Regional differences in gas exchange in the lung of erect man

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Abstract
Measurements of regional ventilation and blood flow using radioactive CO2 show that both increase from apex to base of the lung; the results are used to build an integrated picture of gas exchange. Ventilation-perfusion ratios at nine levels of the lung have been calculated and differences in local gas exchange deduced. In the resulting model, alveolar O2 tension changes by more than 40 mm Hg from apex to base while CO2 and N2 tensions change by about 14 and 29 mm Hg, respectively. Maximal differences in O2 saturation of end-capillary blood are 4% but differences in CO2 contents of 7 vol % and pH variations of 0.12 units occur. The O2 uptake per unit lung volume increases eightfold down the lung while corresponding variations in CO2 output are less than threefold. N2 passes out of the blood in upper parts of the lung but into the blood in basal regions (net exchange is zero). Over-all O2 uptake and CO2 outputs are reduced by only 2–3% by the ventilation-perfusion ratio inequality, causing alveolar-arterial differences of 4, 1, and 3 mm Hg for O2, CO2, and N2, respectively. Submitted on April 6, 1962