Clinical Respiratory Physiology
By Luke Harris
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Clinical Respiratory Physiology - Luke Harris
Clinical Respiratory Physiology
LUKE HARRIS, MB, BS (LOND), MRCP (EDIN)
Consultant Chest Physician and Consultant in Charge, Respiratory Physiology Laboratory, Aintree Unit, Fazakerley Hospital, Liverpool
Consultant Chest Physician, Newsham General Hospital, East Liverpool University Hospital Group
Table of Contents
Cover image
Title page
Copyright
PREFACE
Dedication
SYMBOLS AND ABBREVIATIONS
Chapter 1: Ventilatory Capacity (Timed Spirometry)
Publisher Summary
1 Expiratory Measurements
Inspiratory Measurements
Predicted values for FEV1 based on Age, Height and Sex
Chapter 2: Lung Volumes
Publisher Summary
Closed Circuit Helium Dilution Method for FRC
Open Circuit Nitrogen Washout Method
Whole-body Plethysmography Method
Total Lung Capacity based on Height for Males and Height and Age for Females
Residual Volume as Percentage of Total Lung Capacity
Chapter 3: Ventilation
Publisher Summary
Illustration of Inter-relationship between and
Chapter 4: Oxygen Consumption and Carbon Dioxide Output
Publisher Summary
Chapter 5: Diffusion
Publisher Summary
Steady State Methods
Single Breath Method
Rebreathing Method
Diffusion Coefficient (kCO)
Transfer Factor (Tl) based on Age and Height
Chapter 6: Cardiac Output (Pulmonary Blood Flow)
Publisher Summary
Direct Fick O2 Method
Indirect Fick CO2 Method
Body Plethysmograph Method
Dye Dilution Method
Chapter 7: Ventilation—Perfusion Ratios
Publisher Summary
Radioactive Xenon Method
Anatomical Shunt (Oxygen test)
DETECTION OF SHUNT
MEASUREMENT OF SHUNT
Physiological Shunt and Venous Admixture Effect
Physiological Dead Space
Single Breath CO2 Test
Alveolar-arterial O2 Difference (A – aDO2)
Arterio–alveolar CO2 Difference (a – ADCO2)
Diagrammatic Representation of Effects of Changes in Ventilation–perfusion Ratios
BRONCHOSPIROMETRY
Chapter 8: Compliance and Work of Breathing
Publisher Summary
Work of Breathing
Respiratory Frequency and Work of Breathing
Chapter 9: Airway Resistance
Publisher Summary
Airway Conductance
Chapter 10: Blood Gases
Publisher Summary
Rebreathing Method for P⊽CO2
CO2 dissociation curve for whole blood betweenPco240 and Pco260
HbO2 dissociation curve (pH7.4, temp. 37°C)
Chapter 11: Acid-base Regulation
Publisher Summary
pH
Primary CO2 Retention (Respiratory Acidaemia)
Primary CO2 Depletion (Respiratory Alkalaemia)
Metabolic Acidaemia
Metabolic Alkalaemia
Mixed Disturbances
Chapter 12: Exercise Studies
Publisher Summary
Appendix One: Patterns of Disturbed Function
Appendix Two: Temperature and Pressure Corrections
BIBLIOGRAPHY
INDEX
Copyright
© JOHN WRIGHT & SONS, LTD. 1975
All Rights Reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of the copyright owner.
ISBN 0 7236 0374X
PRINTED IN GREAT BRITAIN BY HENRY LING LTD.
AT THE DORSET PRESS, DORCHESTER
A SUBSIDIARY OF JOHN WRIGHT AND SONS LTD.
PREFACE
The purpose of this short text is to try to clear up some of the difficulties which a succession of Housemen and Registrars have asked me to explain. I have therefore stressed the practical aspects of applied respiratory physiology together with those theoretical concepts that I feel are necessary for proper understanding. The book will, I hope, meet the basic requirements of junior doctors working in respiratory units and those studying for higher qualifications. It should be of value to technicians in respiratory laboratories, and to General Physicians wishing for a brief review of the subject. It may even stimulate an interest in senior medical students, whose knowledge of respiratory physiology is regrettably often precarious.
I have deliberately refrained from cluttering up the text with references. Indeed to quote them all would at least double the size of the book. Instead I have included a bibliography at the end. The books listed have been of great value to me over the years and contain many hundreds of references. The really interested reader of my little book will undoubtedly wish to turn to them.
L.H.
November 1974
Dedication
TO MY WIFE AND CHILDREN
IN GRATITUDE FOR THEIR ENCOURAGEMENT
SYMBOLS AND ABBREVIATIONS
Ventilatory
PRIMARY
V= volume
= volume/unit time
P = pressure
F= fractional concentration
R= respiratory exchange ratio (without subscript) and also resistance (with subscript)
TL= transfer