Effect of Exercise and Disease on the Pulmonary Ventilation and Circulation

Abstract

Twenty-five patients with diverse pulmonary diseases were studied with chest radiography, spirometry, diffusion capacity measurements, differential spirometry and lung scanning. The differential spirometry was performed at rest and during exercise, and the data were analysed by grouping the patients according to the radiographic findings, spirometry and diffusion capacity.Results of spirometry and DLco correlated poorly with the functional evaluation obtained with differential spirometry. A better relationship was seen between the radiographic evaluation and the resting differential spirometry data. However, radiographic evaluation was not a good index of the functional reserve of a lung. .Individual variations were considerable, and it was not possible to predict the functional reserve of a lung from resting differential spirometry data in individual patients.Lung scans were obtained in nine patients at rest and in seventeen patients during exercise. The correlation between the differential oxygen uptake and the radioactivity of the scan in the lung was found to be excellent. The perfusion of each lung, thus, could be determined at rest as well as during exercise by this method.A simultaneous evaluation of ventilation and perfusion of individual lung and its functional reserve by determination of the same parameters, during exercise, is essential particularly when chest surgery is contemplated. Such information can easily be obtained at present, in our opinion, only by differential spirometry.

Factors Influencing the Diffusing Capacity of Each Lung

“…3). The difference between the two values for VO2 was statistically significant too, and this and the difference between the ventilations is due to the fact that the patient's metabolism during differential spirometry is similar to that en countered during moderate exercise [9], The correlation coefficient between theVC>2 of the right lung in percent and the radioactivity in percent of the same lung was excellent (r=0.98 p <0.001) ( fig. 4) and similar to that found in other studies [21][22][23][24].…”

“…Differential spirometry, when performed during exercise, is done by us ing the Carlens catheter [6]. The purpose of this study is to find out the func tional reserve of each lung [7][8][9]. The total capacity (TLC) and the timed vital capacity of each lung (FEVT) have been studied also with differential spiro metry [10][11], K anagami et at.…”

Pulmonary Function and Lung Resection

“…distribution of regional lung function was ascertained by radiological methods, differential spirometry and regional lung function studies with radioisotopes [2], The differential spirometry, 133Xenon studies and pulmonary gammagraphy with intravenous injection of particles were done first at rest and if there was a significant ventilatory or circulatory defect the test was performed during exercise which was con sidered maximal if the pulse rate was at least 120/min [3]. If the operation to be performed was a pneumonectomy, a differential spirometry was done even though the results from global pulmonary function studies did not contraindicate surgery.…”