The ventilation of bullae and the effect of their removal on thoracic gas volumes and tests of over-all pulmonary function.

Abstract

In 18 patients with bullous emphysema who were treated surgically, the most consistent changes in pulmonary function were an increase in arterial oxygen tension and a reduction in functional residual capacity measured by body plethysmography. Increases in the forced expiratory volume in one second after surgical treatment were less consistent and were largest in patients who preoperatively had had the least severe generalized airway obstruction. Tests of regional and over-all pulmonary function suggested that the functional impairment caused by bullae was usually due to their compression of surrounding lung. in only 1 of 14 patients was there convincing evidence that the bulla was acting as a site of significant dead space ventilation. These results implied that in most patients over-all lung function tests can be used to assess the state of the nonbullous lung. When these tests showed changes suggestive of widespread emphysema, the chances of bullectomy leading to a significant clinical and functional im...