DETERMINATIONS OF PHYSIOLOGICAL DEAD-SPACE AND ALVEOLO-ARTERIAL OXYGEN GRADIENTS BY THE INDIRECT METHODS OF RILEY AND ENGHOFF III. STUDIES IN PATIENTS WITH PULMONARY TUBERCULOSIS

Journal/Book: Reprint from The Scandinavian Journal of Clinical & Laboratory Investigation. 1962. Vol. 14 No. 5.. 1962;

Abstract: From the Department of Chest Diseases Rikshospitalet Oslo Norway Received for publication March 23 1962. CONCLUSION AND SUMMARY In 48 cases of pulmonary tuberculosis most of them with extensive and surgically treated disease of long duration (A-a)O2i gradients and/or Vdi X 100/VT ratios are increased in 19 cases. Pathological values are most frequently found in older patients and in the cases with disease of long duration. Pathological (A-a)O2i gradients are encountered in 7 of 13 cases where artificial pneumothorax had been the only surgical treatment. Since a mean (A-a)O2i gradient of 20 mmHg is found for this group this must imply that severe impairment of the respiratory function is encountered in a large number of patients previously treated by artificial pneumothorax. Increased Vdi X 100/VT ratios are mainly found when thoracoplasty has been performed. The mean Vdi X 100/VT ratio for this group as high as 43.4 with a maximal value of 60.0. The Vdi X 100/VT ratio is especially increased in the thoracoplasty cases with marked dyspnea. A pathological (A-a)O2i gradient is found in only one of the 6 cases where resection had been performed and an increased Vdi X 100/VT ratio was not encountered in any of these Gases even when thoracoplasty had previously been done an the same side in 5 of the patients. In the cases where no artificial pneumothorax or other surgical treatment had been performed pathological (A-a)O2i values were found only in 2 elderly men where clinical and spirometric findings suggested emphysema. The increases of the (A-a)O2i gradients and the Vdi X 100/VA ratios are not well correlated to the spirometric findings. ___MH

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