Regional lung function in patients with hepatic cirrhosis

F. Ruff; J. M. B. Hughes; N. Stanley; D. McCarthy; R. Greene; A. Aronoff; L. Clayton; J. Milic-Emili

doi:10.1172/JCI106739

^{Clinical Respiratory Research Group, Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, England}

^{Department of Medicine, Royal Free Hospital, London, England}

^{Department of Medicine, Royal Victoria Hospital, Montreal, Canada}

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^{Clinical Respiratory Research Group, Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, England}

^{Department of Medicine, Royal Free Hospital, London, England}

^{Department of Medicine, Royal Victoria Hospital, Montreal, Canada}

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^{Clinical Respiratory Research Group, Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, England}

^{Department of Medicine, Royal Free Hospital, London, England}

^{Department of Medicine, Royal Victoria Hospital, Montreal, Canada}

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^{Clinical Respiratory Research Group, Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, England}

^{Department of Medicine, Royal Free Hospital, London, England}

^{Department of Medicine, Royal Victoria Hospital, Montreal, Canada}

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^{Clinical Respiratory Research Group, Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, England}

^{Department of Medicine, Royal Free Hospital, London, England}

^{Department of Medicine, Royal Victoria Hospital, Montreal, Canada}

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^{Clinical Respiratory Research Group, Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, England}

^{Department of Medicine, Royal Free Hospital, London, England}

^{Department of Medicine, Royal Victoria Hospital, Montreal, Canada}

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^{Clinical Respiratory Research Group, Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, England}

^{Department of Medicine, Royal Free Hospital, London, England}

^{Department of Medicine, Royal Victoria Hospital, Montreal, Canada}

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^{Clinical Respiratory Research Group, Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, England}

^{Department of Medicine, Royal Free Hospital, London, England}

^{Department of Medicine, Royal Victoria Hospital, Montreal, Canada}

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Published in Volume 50, Issue 11 on November 1, 1971
J Clin Invest. 1971;50(11):2403–2413. https://doi.org/10.1172/JCI106739.
© 1971 The American Society for Clinical Investigation

Published November 1, 1971 - Version history

The lung volume at which the dependent lung zones begin to trap gas as a result of airway closure (i.e., the “closing volume”) was measured with ¹³³Xe in 10 seated patients with hepatic cirrhosis. In all of them the closing volume was increased above normal, and in eight it was greater than the functional residual capacity, indicating the presence of airway closure and gas trapping during resting tidal volume breathing. Direct measurements made with ¹³³Xe in five cirrhotic patients (a) confirmed the presence of increased gas trapping in the lower lung zones both at residual volume and at functional residual capacity, and (b) indicated that in liver cirrhosis the ventilation-perfusion ratio of the dependent lung zones may be very low, primarily as a result of decreased ventilation due to airway closure. It is concluded that in hepatic cirrhosis, gas trapping in the dependent lung zones may be an important cause of impaired gas exchange within the lungs. It is suggested that the premature airway closure observed in this disease may be due to mechanical compression of small airways by dilated blood vessels and/or interstitial pulmonary edema.