LUNG COMPLIANCE & SURFACTANT

By Dr . M. Anth on y Da vid , MD . Pr ofes sor o f P hys io log y

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LUNG COMPLIANCE
The ‘ st re tch abili ty ’ o f th e lung is ca ll ed it’ s C omp li ance .  Co mp li ance is defin ed a s t he volume chan ge per unit pressure chan ge d urin g in fla tion o r de flation.  Volume chan ge : V 2 – V1
 

Pre ssu re C han ge: P 2 – P 1
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LUNG COMPLIANCE

Comp lia nce = V 2 – V1 P2 – P 1 = ∆V
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Lung Compliance
70

V2 V1 V O L U M E

60 50 40 30 20 10 0 0 2 4 6

P1

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PRESSURE

8

P2

10

12

14

16
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LUNG COMPLIANCE

Co mp li ance :
• St at ic • Dyn ami c: c onsi ders tim e di me nsion a lso . • Spe cif ic = Sta tic Compl ia nc e FRC Use d f or c ompa ri ng l ungs of di ff erent siz es .
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RESISTANCE
The op po st ion to th e flo w o f ai r in th e re spi rato ry p ass ages i s ca ll ed as Resista nce .  TY PE S O F RE SIS TANC E:

• AIRW AY • VISC OUS • ELAST IC
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AIRWAY RESISTANCE
 

The re si sta nc e a ir enc ou nte rs whi le pa ss ing throu gh the ai rwa ys. Re si st anc e depends o n the t one of the Re spi rato ry smo ot h m us cle . This acc ou nts f or 20% of t he Re spi rat ory w ork done.

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VISCOUS RESISTANCE
The r esistan ce offer ed b y t he ope ni ng up of t he l ung tissu es.  Acco un ts fo r 20% o f th e wo rk do ne.  Is ca use d by th e o pen in g up o f th e t iss ue s and th e lun gs to a ir.

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ELASTIC RESISTANCE
Is o ffe re d by th e el astic re co il o f th e lun gs durin g in sp ir atio n.  Decrea ses i n dise ase s like Emp hy se ma.  In cre ase s in Fibros is.  Co ntri but es t o 60% o f th e wo rk do ne.

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REVIEW

Lung Compli ance i s de fi ned a s the vol ume c hang e per u nit pre ssu re chang e du ring inf la ti on o r def la tio n. Lung Compli ance = ∆ V

∆ P  The op po sitio n t o flo w air encou nters i s ca ll ed a s re sistan ce .
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REVIEW

Types of resistance :
• Airway • Viscous • Elastic

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WORK OF BREATHING
Is th e wo rk do ne for b rea thin g  Basi cal ly ne ede d to o ve rcom e Resista nce :

• Elast ic re sis ta nc e: 60 % • Airw ay re si st ance: 20% • Visc ou s res is ta nce: 20%

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AIR DISTRIBUTION IN THE LUNGS
Th e depen den t pa rts v en tila te we ll .  Th e depen den t pa rt or th e base of th e lung s has:

• Less rec oi l • Be tt er ve ntil ati on.
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APEX

BASE

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FLOW VOLUME CURVE
50

Flow Rate 0
TLC

RV

Lung Volume
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PRESSURE – VOLUME CURVES

Obtained by plotting different lung volumes against respective trans pulmonary pressures. Depict the relationship between Pressure & Volume of the lung.

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PRESSURE – VOLUME CURVES

In fla tio n cu rv e: F la t- st eep- fla t
• Easi est inf la tion a t mode rate pre ssu res .

Hystere sis: G ap betwe en th e infl ation a nd defl atio n curve s.
• Ca us e: Su rf ace t ensi on of the Alve ol ar fl uid. • Not s ee n wi th sa li ne.
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PULMONARY SURFACTANT

A chemical secreted by by the type II Alveolar cells. Composition:
• Dipalmitoyl Lecithin. • Phosphatidyl Glycine. • Other Phospholipids. • Neutral lipids. • Proteins & Carbohydrates
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SURFACTANT MOLECULE

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PULMONARY SURFACTANT

FUNCTIONS:
• Reduces the surface tension of the thin film of alveolar fluid. This makes it easier to inflate the lungs. • Increases the Lung Compliance. • Prevents the Tissue fluid formation.
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Surfactant: Function

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Surfactant: Applied Aspects

INF ANT R ES PIR ATORY D IS TR ES S SYND ROME( IRD S) :
• Als o c alle d Hya li ne Membra ne Dise as e. • Ca n be f ata l. • Se en i n pr ema tu re b abi es :

As th e sur fac tan t prod uc ti on h as not begun in th em
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Surfactant: Applied Aspects

Adult Respiratory Distress Syndrome(ARDS):
• Primarily due to cigarette smoking.

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