Abstract
An actual value for respiratory exchange ratio (R) was compared with a value assumed to be 0.8 in the calculation of the alveolar-arterial oxygen pressure gradient (P(A-a)O2), both by theoretical analysis and analysis of results in patients with stable chronic pulmonary disease. These comparisons demonstrated that except for a few well-defined exceptional circumstances, the assumed value is sufficiently accurate for clinical purposes. Using an assumed R of 0.8, the P(A-a)O2 was measured, as was the closing volume (CV) of the lung in 66 normal nonsmoking subjects between 20 and 82 years of age. A significant correlation between P(A-a)O2 and CV was demonstrated and it is concluded that the increasing P(A-a)O2 with advancing age results from a concomitant progressive occurrence of airway closure in the tidal volume range.
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