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WTSA: Impact of Pulmonary Vascular Compliance on Pleural Effusion...
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Pulmonary compliance (or lung compliance) is the ability of the lungs to stretch during a change in volume relative to an applied change in pressure.[1]

Compliance is greatest at moderate lung volumes, and much lower at volumes which are very low or very high.

Contents

[edit] Clinical significance

It is an important measurement in respiratory physiology.[2][3][4]

  • fibrosis is associated with a decrease in pulmonary compliance.
  • emphysema/COPD may be associated with an increase in pulmonary compliance due to the loss of alveolar and elastic tissue.

Pulmonary surfactant increases compliance by decreasing the surface tension of water. The internal surface of the alveolus is covered with a thin coat of fluid. The water in this fluid has a high surface tension, and provides a force that could collapse the alveolus. The presence of surfactant in this fluid breaks up the surface tension of water, making it less likely that the alveolus can collapse inward. If the alveolus were to collapse, a great force would be required to open it, meaning that compliance would decrease drastically.

[edit] Functional significance of abnormally high or low compliance

Low compliance indicates a stiff lung and means extra work is required to bring in a normal volume of air. This occurs as the lungs in this case become fibrotic, lose their distensibility and become stiffer.

In a highly compliant lung, as in emphysema, the elastic tissue has been damaged, usually due to their being overstretched by chronic coughing. Patients with emphysema have a very high lung compliance due to the poor elastic recoil, they have no problem inflating the lungs but have extreme difficulty exhaling air. In this condition extra work is required to get air out of the lungs.

[edit] Calculation

Compliance is calculated using the following equation, where ΔV is the change in volume, and ΔP is the change in intrapleural pressure:[5]

C =  \frac{ \Delta V}{ \Delta P}

For example if a patient inhales 500 mL of air from a spirometer and intrapleural pressure before inspiration is – 5 cm H2O and -10 cm H2O at the end of inspiration. Then:
 Compliance = \frac{\Delta V}{\Delta P} = \frac{.5\;L}{(-5\;cmH_2O - (-10\;cmH_2O))} = \frac{.5\;L}{5\;cmH_2O} = 0.1\;L\;\times\;cmH_2O^{-1}

[edit] References

  1. ^ MeSH Lung+compliance
  2. ^ Compliance
  3. ^ Nikischin W, Gerhardt T, Everett R, Bancalari E (1998). "A new method to analyze lung compliance when pressure-volume relationship is nonlinear.". Am J Respir Crit Care Med 158 (4): 1052–60. PMID 9769260.  article
  4. ^ Physiology at MCG 4/4ch2/s4ch2_21
  5. ^ Vascular compliance





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