Presentation on theme: "Helium Dilution Method: To measure FRC, RV & TLC"— Presentation transcript:
1Helium Dilution Method: To measure FRC, RV & TLC FRC: Volume of air that remains in lung at the end of normal expiration. Helpful for lung function.Significance: Changes in some types of pulmonary diseases. Helps in diagnosis.Limitation: Spirometer cannot measure it directly as the air in the residual volume of the lungs, cannot be expired into the spirometer. This RV is nearly ½ FRC.So, spirometer is used in an indirect manner to measure FRC, by means of HELIUM DILUTION METHOD.
2Helium Dilution Method: PROCEDURE:A Spirometer of known volume is filled with air mixed with helium at a known conc.Before breathing from the spirometer, the person expires normally.At the end of tidal expiration, remaining volume in the lungs = FRC.At this point subject immediately begins to breathe from the spirometer gases of spirometer mix with gases of the lungs.
3Helium Dilution Method: helium becomes diluted by FRC gases & volume of FRC can be calculated from the degree of dilution of helium, using the formula:Ci He = initial conc. of helium in spirometer.Cf He = final conc. of helium in spirometer.Vi Spir = initial volume of spirometer.
4Measurement of RV & TLC: Calculation of RV:FRC – ERV = RVERV is measured from normal spirometry.Calculation of TLC:FRC + IC = TLCIC is measured from normal spirometry.
5DEAD SPACE: Anatomical & Physiological function & Protective Reflexes:
7DEAD SPACE: Definition: It is the portion of inspired air that does not take part in gaseous exchange with pulmonary capillary blood.Its extent is from nose up to terminal bronchiole.Value: It is equal to 150 ml.
8VT = 500 ml350 ml alveoli150 ml remains in conducting airways (up to terminal bronchioles)= Dead space
9TYPES OF DEAD SPACE Anatomical Dead Space Physiological Dead Space Anatomical Dead Space= Consists of conducting airways, i-e., 150 ml.
11Alveolar dead space:Consists of non-functional or partially functional alveoli because of lack of perfusion.The inspired air which goes to non-functional alveoli is of no benefit & no exchange takes place in result WASTAGE VENTILATION.
12Whenever there is alveolar dead space, it is wastage ventilation. Physiological dead space = Anatomical dead space + Alveolar dead spaceNormally there is no Alveolar dead space, so Anatomical dead space = physiological dead space / total / functional dead space.When alveolar dead space is present physiological dead space increases and is greater than anatomical dead space.
13When we expire out,first 150 ml is expired out from the dead space & then 350 ml from ventilation area is expired.
14ADVANTAGE OF DEAD SPACE? Conditioning of inspired air which includes warming & humidification & filteration.
15Effect of Tracheostomy on dead space! There is exclusion of dead space no conditioning of inhaled air complications.
16MeasurementAnatomical dead space is measured by Nitrogen washout Method.Subject is asked to have a deep breath of pure oxygen.Then asked to expire in nitrogen meter & measure the nitrogen content of expired air.Record of changes in nitrogen conc. in expired airafter singe previous inspiration of pure oxygen
18Measurement Physiological dead space is measured by Bohr’s Method. Formula: VD = VT (PaCO2 – PeCO2)PaCO2= 500 (42 – 28)= 150 ml42VD = Dead space,VT = Tidal volume,Pa = partial pressure of alveoli,Pe = partial pressure of expired air
19Dead space slightly increases: With Age (in old age elasticity of alveoli is less fully functional alveoli are less physiological dead space increases).In males (anatomical dead space is more)On StandingDuring deep inspiration (in young men) due to expansion of airway containing no alveoli.When a person breathes from a long tube (during anesthesia or artificial respiration).
20Dead space slightly decreases: On tracheostomy (breathing through a hole made surgically in trachea).Anatomical dead space may fall to 110 ml during expiration, as expiration is accompanied by constriction of airways.
21Functions of LUNG: Respiratory functions: Non-Respiratory functions Exchange of gases in lungs.Non-Respiratory functions
22Non-Respiratory functions of lungs: 1) SYNTHETIC FUNCTION:Synthesis of:SurfactantHeparinHistamineSerotoninPGsConversion of Angiotensin I Angiotensin IIIn endothelial cells of lung capillaries, there is enzyme ACE (Angiotensin Converting Enzyme) for it.
23Non-Respiratory functions of lungs: 2) REMOVAL OF SOME SUBSTANCES INCLUDING AMINES:APUD cells (Amine Precursor uptake and Decarboxylation Cells) in lungs remove histamine, serotonin (amines).
24Non-Respiratory functions of lungs: 3) LUNGS HAVE blood FILTERING FUNCTION:Small blood clots are filtered out when blood flows through lungs.
25Non-Respiratory functions of lungs: 4) RESERVOIR FUNCTION:In blood vessels of lungs, 450 – 600 ml blood is stored.It can be expelled in general circulation, if required.This blood can serve to maintain left ventricular stroke volume for a few beats, even if right ventricular output may fall to zero.
26Non-Respiratory functions of lungs: 5) ACID BASE BALANCE:lungs hypoventilate to compensate for metabolic alkalosis.lungs hyperventilate to compensate for metabolic acidosis.
27Non-Respiratory functions of lungs: 6) TEMPERATURE REGULATION:From surface of airways, there is insensible perspiration heat loss.
28Non-Respiratory functions of lungs: 7) WATER BALANCE OF THE BODY:By insensible perspiration from surface of airways.
29Non-Respiratory functions of lungs: 8) ROUTE OF DRUG ADMINISTRATION:Respiratory system is a route of administering drugs like:AnesthesiaOther drugs (inhalers)
30Non-Respiratory functions of lungs: 9) INVOLVED IN PHONATION:Spoken speech has 3 processes:1) Phonation: it is sound production in voice box / larynx by vocal cord vibration. Expired air sets the vocal cords into vibration.2) Articulation3) Resonance
31Non-Respiratory functions of lungs: 10) METABOLIC & ENDOCRINE FUNCTION:Lungs synthesize certain Prostaglandins, e.g., PGE2.Histamine, heparin & Kallikrein are also produced in lungs.Release of excessive amounts of histamine & several other chemical mediators from mast cells in antigen-antibody reactions is the basis of pulmonary allergic disorders, like bronchial asthma, as these chemicals narrow the airways by:constricting bronchiolar smooth muscle &producing mucosal edema.
32Non-Respiratory functions of lungs: d. Partial inactivation of certain circulating compounds like:Bradykinin (a vasodilator) is inactivated by Angiotensin IINor-epinephrineAcetylcholineFibrin clots
33Non-Respiratory functions of lungs: f. In certain lung diseases like Tuberculosis &Lung Abscess, lung cancer There is abnormal secretion of hormones like vasopressin (ADH) & ACTH.
34Non-Respiratory functions of lungs: 11) DEFENCE FUNCTION:Mucus: Produced by goblet cells & bronchial glands.mucus layer can trap small particles entering the bronchial tree.Mucus has lysozyme & antibodies (IgA) with antibacterial activity.Ciliary epithelium is an important defence mechanism.
35Non-Respiratory functions of lungs: Lungs contain lymphocytes & plasma cells which antibodies.Pulmonary alveolar macrophages act as scavengers (against silica, asbestos, cigarette smoke).
36Non-Respiratory functions of lungs: 12) MISCELLANEOUS FUNCTIONS:Alternate inspiration & expiration help in venous returnLungs make surfactant keeps the alveoli expanded.