In addition, the increase in intrathoracic pressure reduces venous return to the right ventricle, which in turn reduces pulmonary artery pressure. In the lung apices, the increase in alveolar pressure causes compression of the pulmonary capillaries, reducing alveolar perfusion. Positive end-expiratory pressure and positive pressure ventilation both increase alveolar pressure. Like upright posture, this leads to insufficient perfusion of the lung apices, a high V̇/ Q̇ ratio and thus an increase in VDAlv. Low pulmonary artery pressure for example, as a result of reduced right ventricular output. The apical alveoli are well ventilated but not adequately perfused, which increases VDAlv. Owing to the effect of gravity, blood only just perfuses the lung apices (i.e.
However, VDAlv may increase as a result of: In normal lungs, VDAlv is negligible as alveolar ventilation and perfusion are well matched. 48) and VDAnat is measured using Fowler’s method. VDPhys is measured using the Bohr equation (see p. As VDPhys=VDAnat+VDAlv, the alveolar dead space can be calculated if VDPhys and VDAnat are known.
How is alveolar dead space measured and what factors affect it?Īlveolar dead space cannot be measured directly.
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