VENTILATION

DESCRIBE ALVEOLAR AND PULMONARY VENTILATION

Symbo
Measurement Equation Description
l

Minute ventilation / = TV x breathing

E the total volume of air entering the lungs per minute.
Pulmonary Ventilation frequency 

= (TV – VDana) x
Alveolar ventilation breathing Volume of new air that enters the alveoli per minute
frequency

Volume of air in alveolus that does not receive sufficient

perfusion compared to ventilation but instead remains in the
Dead space ventilation = dead space  airways (trachea, bronchi, etc.).

Normal value = 150 ml

Measure Sample value

Tidal volume 0.5 L

Respiratory rate 15 breaths/minute

Minute ventilation 7.5 L/min

Dead space 0.1667 L

Dead space ventilation 2.5 L/min

Alveolar ventilation 5.0 L/min

PHYSIOLOGICAL DEAD SPACE

1. Total dead space (also known as "physiological" dead space) can be divided into anatomical dead space and
alveolar dead space.
2. Anatomical dead space
- Anatomical dead space is the gas in the conducting areas of the respiratory system, such as
the mouth and trachea, where air does not come into contact with the alveoli of the lungs.
- It is normally equal in milliliters to your body weight in pounds. A 150 lb (68 kg) male would have an
anatomical dead space of about 150 mL. 1 mL per lb or 2.2 mL per kilogram of body weight.
- This is the same conversion of kilograms to pounds, except the final unit is in mL. This is about a third of the
resting tidal volume (450-500 mL).
- Anatomic dead space is the volume of the conducting airways. It may be measured by Fowler's method,
a nitrogen washout technique.
3. Alveolar dead space
- Alveolar dead space is caused by air contacting alveoli without bloodflow in their adjacent
pulmonary capillaries, i.e. ventilation with out perfusion.
- As a result, no gas exchange can occur.
- Alveolar dead space is negligible in healthy individuals, but can increase dramatically in some lung diseases.
4. Bohr equation
- Anatomical and alveolar dead space can both be measured using the Bohr equation.[6][7] Formally, Bohr's
method is used to calculate the former.
- In practice, it is more commonly used to calculate the latter.
- The Bohr equation states that the dead space (V d) is calculated as follows:

- where Vd is dead space volume, Vt is tidal volume, PaCO2 is the partial pressure of carbon dioxide in the
arterial blood, and PeCO2 is the partial pressure of carbon dioxide in the expired air.
- Depending on how the expired CO2 is measured, this equation gives the physiological or alveolar dead space

DESCRIBE PARTIAL PRESSURE OF RESPIRATORY GASES

1. Dalton’s Law (mixture of gas in a container exerts a sum total of pressure)

2. Directly proportional to temperature and concentration on gas
3. Total atmospheric pressure (due to all pressures exerted by various gases in atmosphere)
ALVEOLAR GAS EQUATION
P A C O2
1. PAO2 = PIO2 -
R
2. R is the Respiratory quotient (normally about 0.8)
3. pAO2 is the Alveolar pO2
4. pIO2 is the Inspired pO2, equal to about 150 mm Hg (0.21 x 713 mmHg at sea level).
5. The given pressure at sea level is due to atmospheric pressure (760 mmHg) minus the partial pressure of
water vapor (47 mmHg), as alveolar gas is completely saturated with water.
6. The mole fraction of oxygen is about 0.21 in dry atmospheric gas.
7. pACO2 is the Alveolar pCO2 (assumed to be equal to the measured arterial pCO 2)

HYPERVENTILATION

1. Alveolar ventilation greater than what is required to maintain P aCO2 and PaO2
2. Caused by
- High altitude
- Emotional state (hysteria)
- Metabolic acidosis
- Infection in brain
- Fever
- Artificial respiration
- Hormones (adrenaline, progesterone, thyroxine)

3. If carbon dioxide levels are high, the body assumes that oxygen levels are low, and accordingly, the brain's
blood vessels dilate to assure sufficient blood flow and supply of oxygen.
4. Conversely, low carbon dioxide levels cause the brain's blood vessels to constrict, resulting in reduced blood
flow to the brain and lightheadedness.
5. The gases in the alveoli of the lungs are nearly in equilibrium with the gases in the blood.
6. Normally, less than 10% of the gas in the alveoli is replaced with each breath taken.
7. Deeper or quicker breaths as in hyperventilation exchange more of the alveolar gas with ambient air and
have the net effect of expelling more carbon dioxide from the body, since the carbon dioxide concentration
in normal air is very low.
8. The resulting low concentration of carbon dioxide in the blood is known as hypocapnia.
9. Since carbon dioxide is carried as carbonic acid in the blood, hypocapnia results in the blood
becoming alkaline, i.e. the blood pH value rises. This is known as a respiratory alkalosis.
10. This alkalinization of the blood causes vessels to constrict (vasoconstriction); it is theorized
that myofibrillar calcium sensitivity is increased in the presence of high pH value.
11. The high pH value resulting from hyperventilation also reduces the level of available calcium (hypocalcemia),
which affects the nerves and muscles, causing constriction of blood vessels and tingling.
12. This occurs because alkalinization of the plasma proteins (mainly albumin) increases their calcium binding
affinity, thereby reducing free ionized calcium levels in the blood.
 13. Therefore, there are two main mechanisms that contribute to the cerebral vasoconstriction that is
responsible for the lightheadedness, parasthesia, and fainting often seen with hyperventilation.
14. One mechanism is that low carbon dioxide (hypocapnia) causes increased blood pH level (respiratory
alkalosis), which causes blood vessels to constrict.
15. The other mechanism is that the alkalosis causes decreased freely ionized blood calcium, thereby causing
cell membrane instability and subsequent vasoconstriction and parasthesia.

HYPOVENTILATION

1. Consumption of oxygen is greater than oxygen supplied by ventilation

2. Caused by
- Depression of respiratory centre
- Inspiratory muscle paralysis
- Restrictive pulmonary disease
- Blockage of airways
3. The state in which a reduced amount of air enters the alveoli in the lungs, resulting in decreased levels
of oxygen and increased levels of carbon dioxide in the blood.
4. Hypoventilation can be due to breathing that is too shallow (hypopnea) or too slow (bradypnea) or to
diminished lung function.