June 20, 1968New England Journal of Medicine
Site and Nature of Airway Obstruction in Chronic Obstructive Lung Disease
Authors
Discussion
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Implication
Ex vivo study reveals marked peripheral airway resistance in chronic obstructive lung disease, indicating extensive silent obstruction before clinical detection.
Key Points
- To identify the precise anatomical location and pathological mechanisms driving increased airway resistance in chronic obstructive lung disease.
- Catheters were wedged into 2- to 3-mm airways of excised human lungs to partition total resistance into central (Rc) and peripheral (Rp) components across five normal lungs, seven emphysematous lungs, and individual cases of bronchiectasis and bronchiolitis.
- Bronchographic and histological evaluations were performed to identify structural causes of peripheral flow resistance.
- Peripheral resistance (Rp) accounted for 25% of total resistance in normal lungs (mean 0.18 cm H2O/L/s), but increased 4- to 40-fold in emphysematous lungs.
- Central airway resistance (Rc) remained near normal values across all specimens, while elevated Rp stemmed directly from mucus plugging, luminal narrowing, and airway obliteration.
Cite This Study
Hogg et al. (1968) studied this question.