Delineation of flow-limiting segment and predicted airway resistance by movable catheter

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Abstract
Using intrabronchial lateral pressure catheters, we determined the precise location and movement of the flow-limiting segment (FLS) in excised dog and human lungs; under maximal flow conditions, profiles of resistance and transmural pressure from the “mouth” to segmental bronchi were also obtained. In the same lungs, using the interrupter technique, IVFP curves were constructed; with these curves and lung compliance, the relationship between Vmax and Pel was studied using the analysis of Pride et al. The FLS consisted of well-demarcated short lengths (2–3 cm) of the trachea at large lung volumes which moved to lobar or semental bronchi at small volumes (10–20% TLC). These relationships, coupled with observations of the movement of the equal pressure point (EPP), support the idea that in the excised lung the location of the FLS is determined by both the location of the EPP and the compliance of the downstream airway wall; thus FLS MAY NOT FOLLOW UPSTREAM MOVEMENTS OF EPP until EPP reaches a more compliant segment of the bronchial tree (lobar and proximal segmental bronchi). Upstream resistance (Rs) and transmural pressure of collapse (Ptm′) calculated indirectly from the slope and intercept of the Vmax vs. Pel relationship accurately predicted values of resistance and transmural pressure measured directly in the same lungs at a point just upstream to FLS.