Nunn and Lumb's Applied Respiratory Physiology

Acute lung injury

Key points Acute lung injury is lung inflammation that develops in response to a variety of both pulmonary and generalized acute diseases. The clinical features of acute lung injury vary from mild, self-limiting dyspnoea to rapidly progressive and fatal respiratory…

Diseases of the lung parenchyma and pleura

Key points Lung collapse occurs either from compression of lung tissue or by absorption of gas from lung units with occluded or severely narrowed airways. Many forms of interstitial lung disease exist, varying from purely inflammatory conditions (alveolitis) to those…

Pulmonary vascular disease

Key points Pulmonary oedema occurs when increases in pulmonary capillary pressure or the permeability of the alveolar/capillary membrane cause fluid to accumulate in the interstitial space and alveoli. Pulmonary embolism, with either thrombus or air, partially occludes the pulmonary circulation,…

Airways disease

Key points Whatever the cause, airway narrowing leads to expiratory flow limitation, gas trapping and hyperinflation of the lung, which manifests itself as breathlessness. Asthma involves intermittent, reversible airway obstruction caused by airway inflammation and bronchial smooth muscle contraction, both…

Ventilatory failure

Key points Ventilatory failure occurs when alveolar ventilation becomes too low to maintain normal arterial blood gas partial pressures. There are many causes, involving the respiratory centre, the respiratory muscles or their nerve supply and abnormalities of the chest wall,…

Comparative respiratory physiology

Key points The animal kingdom contains a myriad of solutions to the challenge of respiratory gas exchange, such as integument respiration, external or internal gills in water or a tracheae system or lung for breathing air. Factors affecting respiratory system…

Oxygen toxicity and hyperoxia

Key points Breathing oxygen at increased atmospheric pressure achieves very high arterial P o 2 values, but venous P o 2 , and therefore minimum tissue P o 2 , only increases at 3 atm absolute pressure. Normal metabolic processes,…

Anaemia

Key points Anaemia has little effect on pulmonary gas exchange but decreases oxygen carriage in the arterial blood in direct proportion to the reduction in haemoglobin concentration. Mechanisms that compensate for the reduced oxygen delivery include increased cardiac output, increased…

Hypoxia

Key points Intracellular acidosis from anaerobic metabolism occurs soon after the onset of cellular hypoxia and is worse when there is a plentiful supply of blood and glucose to the cell. Lack of high-energy substrates such as adenosine triphosphate (ATP)…

Changes in the carbon dioxide partial pressure

Key points Hypocapnia occurs when alveolar ventilation is excessive relative to carbon dioxide production, and usually results from hyperventilation because of hypoxia, acidosis or lung disease. Hypercapnia most commonly occurs because of inadequate alveolar ventilation from a multitude of causes,…