REGIONAL PULMONARY-FUNCTION IN HEMIDIAPHRAGMATIC PARALYSIS

  • 1 January 1977
    • journal article
    • research article
    • Vol. 13  (6) , 749-761
Abstract
Gaseous exchange and regional pulmonary function (using 133Xe) were studied in 10 subjects with hemidiaphragmatic paralysis. The paralysis was presumably idiopathic in 9 subjects. Global and regional investigations were performed on the same morning, the subjects being studied in the sitting position. Six subjects were obese. Overweight was moderate except in 1 case. Lung volumes were moderately decreased (vital capacity ranged from 69-100% of the predicted value). PaO2 [arterial oxygen tension] was normal or nearly normal: mean = 75.8 .+-. 7.5 torr in the sitting position. PaO2 did not vary significantly in the supine, nor in the lateral recumbent position. A-aDO2 [alveolo-arterial O2 difference], breathing air or during hyperoxia, was slightly increased. .ovrhdot.Qs/.ovrhdot.Qt [left to right shunting of pulmonary blood flow] was markedly increased in 3 cases. Regional lung function data suggest that the paralyzed side still plays an appreciable part in pulmonary volume (43.5 .+-. 6.3%), ventilation (39.1 .+-. 8.2%) and perfusion (40.4 .+-. 9.3%). Impairment of the paralyzed side was mainly localized in the lower zone; in the middle zone only ventilation was significantly reduced. Results of regional ventilation and perfusion, expressed as absolute values, suggest a redistribution of ventilation and perfusion from the base towards the apex, for the paralyzed side and for the opposite side. This adjustment is probably due to the hemidiaphragmatic paralysis, but the possible role of obesity (present in 6 cases) must be kept in mind. Possible therapeutic deductions are discussed.

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