Effects of Surface-Active Aerosols and Pulmonary Congestion on Lung Compliance and Resistance

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Abstract
Pulmonary compliance and resistance were studied in normal subjects after quiet respiration, deep breathing, and the nebulization of surface-active agents. Deep breathing resulted in a significant rise in pulmonary compliance and decrease in airway and tissue resistance. Alcohol nebulizations increased compliance and decreased resistance in normal subjects. Siliconized superinone and water nebulizations had an opposite effect. Simulated pulmonary congestion in normal subjects and congestive heart failure with pulmonary edema inhibited the anticipated response to alcohol aerosols. Responsiveness returned in part to patients with congestive heart failure after restoration of cardiac compensation. These observations suggest that pulmonary vascular congestion is a major cause of altered respiratory mechanics in heart failure. In the presence of pulmonary congestion, surface-active aerosols do not demonstrably affect compliance.