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Mechanics of the Lung in the 20th Century

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Abstract

Major advances in respiratory mechanics occurred primarily in the latter half of the 20th century, and this is when much of our current understanding was secured. The earliest and ancient investigations involving respiratory physiology and mechanics were frequently done in conjunction with other scientific activities and often lacked the ability to make quantitative measurements. This situation changed rapidly in the 20th century, and this relatively recent history of lung mechanics has been greatly influenced by critical technological advances and applications, which have made quantitative experimental testing of ideas possible. From the spirometer of Hutchinson, to the pneumotachograph of Fleisch, to the measurement of esophageal pressure, to the use of the Wilhelmy balance by Clements, and to the unassuming strain gauges for measuring pressure and rapid paper and electronic chart recorders, these enabling devices have generated numerous quantitative experimental studies with greatly increased physiologic understanding and validation of mechanistic theories of lung function in health and disease. © 2011 American Physiological Society. Compr Physiol 1:2009‐2027, 2011.

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Figure 1. Figure 1.

Picture of Jere Mead (c. 1985), who impacted nearly every facet of lung mechanics in the 20th century.

Figure 2. Figure 2.

Picture of Peter Macklem, who trained with Jere Mead, and became a strong advocate of the importance of respiratory mechanics measurements throughout his career. This picture dates from 1988, when Dr. Macklem was honored by his appointment as an Officer of the Order of Canada.

Figure 3. Figure 3.

Deflation pressure‐volume curves of a canine left lung. Curve a shows an air‐inflated lung; curve b shows a saline‐filled lung; and curve c is difference between the two, that is, the calculated elastic recoil force due to surface tension alone. The ordinate shows the pressure in cmH2O and the abscissa shows the volume in milliliters, which is opposite to the more conventional orientation (e.g., see Fig. ). From Neergaard .

Figure 4. Figure 4.

Experimental air and saline pressure‐volume loops from a single cat lung. With air inflation from residual volume, the airways did not begin to open until pressure exceeded 10 cmH2O. Data obtained, with permission, from Radford .

Figure 5. Figure 5.

This figure demonstrates the model by Wilson and Bachofen, which illustrates how surface tension operates in the lung parenchyma consisting of flat alveolar septal walls. The surface forces are large at the corners where the septal walls meet (upper drawing, curvature R) and at the edge of the openings of the alveolar mouths (lower drawing, curves arrowhead lines). The forces at this latter site are large and serve to compress the walls, leading to folding in the corners, as seen in the upper drawing. Figure adapted, with permission, from Wilson and Bachofen .

Figure 6. Figure 6.

The relaxation pressure curve (solid) and its two fractions, that due to the elasticity of the lungs and that due to the chest, diaphragm, etc. (Fig. , from Rahn et al, .

Figure 7. Figure 7.

Regional differences of lung expansion caused by gravity. The vertical axis shows regional lung volume (Vr), expressed as percent of total lung volume (TLC). The horizontal axis shows overall lung volume (V), expressed as percent of TLC below and as percent of VC above. The line of identity indicates the percentile degree of expansion of the regions equal to that of the entire lung. Vertical distance (D) from the top of the lung (in cm) is indicated on each curve. From Milic‐Emili et al, 1966 .

Figure 8. Figure 8.

Predicted airway resistance as a function of airway generation at three different flows and with pure Poiseuille flow [from reference , 1970, Elsevier, used with permission]. This shows that most of the resistance is in the larger conducting airways. The model was based on the symmetric Weibel branching pattern , but a similar conclusion was also found with the asymmetric model of Horsfield and Cumming .

Figure 9. Figure 9.

Schematic showing a retrograde catheter wedged in a peripheral bronchus, exiting through the bronchial wall, parenchyma, and visceral pleura. This approach enabled partitioning of the central and peripheral lung resistance. From Macklem and Mead .

Figure 10. Figure 10.

Schematic reconstruction of the bronchial pathway described by Martin .The letter designations refer to those in the serial sections shown by Martin. (A) and (B) are terminal bronchioles; a1 and b1 are first‐order respiratory bronchioles; a2 and b2 are second‐order respiratory bronchioles; and a3 and b3 are alveolar ducts. The numbers associated with each airway are approximate diameters in millimeters, estimated from the histological sections.

Figure 11. Figure 11.

Two compartment model of the lung parenchyma presented by Otis et al .

Figure 12. Figure 12.

Three‐dimensional graph showing pressure‐flow curves as a function of lung volume in an emphysematous subject, from Fry et al . Ordinate shows expiratory (positive) and inspiratory (negative) flows, abscissa shows pleural pressure, and lung volume is shown on the plane projecting toward the reader.



Figure 1.

Picture of Jere Mead (c. 1985), who impacted nearly every facet of lung mechanics in the 20th century.



Figure 2.

Picture of Peter Macklem, who trained with Jere Mead, and became a strong advocate of the importance of respiratory mechanics measurements throughout his career. This picture dates from 1988, when Dr. Macklem was honored by his appointment as an Officer of the Order of Canada.



Figure 3.

Deflation pressure‐volume curves of a canine left lung. Curve a shows an air‐inflated lung; curve b shows a saline‐filled lung; and curve c is difference between the two, that is, the calculated elastic recoil force due to surface tension alone. The ordinate shows the pressure in cmH2O and the abscissa shows the volume in milliliters, which is opposite to the more conventional orientation (e.g., see Fig. ). From Neergaard .



Figure 4.

Experimental air and saline pressure‐volume loops from a single cat lung. With air inflation from residual volume, the airways did not begin to open until pressure exceeded 10 cmH2O. Data obtained, with permission, from Radford .



Figure 5.

This figure demonstrates the model by Wilson and Bachofen, which illustrates how surface tension operates in the lung parenchyma consisting of flat alveolar septal walls. The surface forces are large at the corners where the septal walls meet (upper drawing, curvature R) and at the edge of the openings of the alveolar mouths (lower drawing, curves arrowhead lines). The forces at this latter site are large and serve to compress the walls, leading to folding in the corners, as seen in the upper drawing. Figure adapted, with permission, from Wilson and Bachofen .



Figure 6.

The relaxation pressure curve (solid) and its two fractions, that due to the elasticity of the lungs and that due to the chest, diaphragm, etc. (Fig. , from Rahn et al, .



Figure 7.

Regional differences of lung expansion caused by gravity. The vertical axis shows regional lung volume (Vr), expressed as percent of total lung volume (TLC). The horizontal axis shows overall lung volume (V), expressed as percent of TLC below and as percent of VC above. The line of identity indicates the percentile degree of expansion of the regions equal to that of the entire lung. Vertical distance (D) from the top of the lung (in cm) is indicated on each curve. From Milic‐Emili et al, 1966 .



Figure 8.

Predicted airway resistance as a function of airway generation at three different flows and with pure Poiseuille flow [from reference , 1970, Elsevier, used with permission]. This shows that most of the resistance is in the larger conducting airways. The model was based on the symmetric Weibel branching pattern , but a similar conclusion was also found with the asymmetric model of Horsfield and Cumming .



Figure 9.

Schematic showing a retrograde catheter wedged in a peripheral bronchus, exiting through the bronchial wall, parenchyma, and visceral pleura. This approach enabled partitioning of the central and peripheral lung resistance. From Macklem and Mead .



Figure 10.

Schematic reconstruction of the bronchial pathway described by Martin .The letter designations refer to those in the serial sections shown by Martin. (A) and (B) are terminal bronchioles; a1 and b1 are first‐order respiratory bronchioles; a2 and b2 are second‐order respiratory bronchioles; and a3 and b3 are alveolar ducts. The numbers associated with each airway are approximate diameters in millimeters, estimated from the histological sections.



Figure 11.

Two compartment model of the lung parenchyma presented by Otis et al .



Figure 12.

Three‐dimensional graph showing pressure‐flow curves as a function of lung volume in an emphysematous subject, from Fry et al . Ordinate shows expiratory (positive) and inspiratory (negative) flows, abscissa shows pleural pressure, and lung volume is shown on the plane projecting toward the reader.

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Wayne Mitzner. Mechanics of the Lung in the 20th Century. Compr Physiol 2011, 1: 2009-2027. doi: 10.1002/cphy.c100067