Abstract
The characteristic physiologic abnormality that defines chronic obstructive pulmonary disease (COPD) is a decrease in the maximal expiratory flow. Mead and his associates [1] developed the concept that during forced expiration lateral pressures at points within the airways become equal to pleural pressure and that the pressure driving flow from the alveoli to these equal pressure points approximates the static recoil pressure of the lung. This means that forced expiratory flow can be reduced by (1) a loss of lung elasticity, (2) an increase in resistance of the airways upstream from the equal pressure points, and/or (3) an increase in the compliance of airways downstream from equal pressure points. Over the past 15 years we have collected data on lung function and structure on more than 400 patients who have had a surgical resection of a lung or lobe. Despite a remarkably uniform smoking duration and intensity and a narrow age distribution these patients show a wide variation in the degree of airway obstruction. The purpose of this chapter is to examine the factors that determine maximal expiratory flow in an attempt to define the relative importance of loss of lung elastic recoil and peripheral airways obstruction to the reduction in forced expiratory flow.
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Paré, P.D., Hogg, J.C. (1995). Lung Structure-Function Relationships. In: Calverley, P.M.A., Pride, N.B. (eds) Chronic Obstructive Pulmonary Disease. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-4525-9_3
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DOI: https://doi.org/10.1007/978-1-4899-4525-9_3
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