Effect of local pulmonary blood flow control on gas exchange: theory.

Abstract

The effect of local pulmonary blood flow control by local alveolar O2 tension on steady-state pulmonary gas exchange is analyzed with techniques derived from control theory. In a single homogeneous lung unit with normal inspired and mixed venous blood gas composition, the homeostatic effect on local ventilation-perfusion ratios (VA/Q) regulation occurs over a restricted range of VA/Q. The homeostatic effect is maximal at a moderately low VA/Q (about 0.4) due to the slope of the O2 dissociation curve. In a multicompartment lung with a lognormal distribution of VA/Q, regulation of arterial O2 tension varies with the extent of inhomogeneity. At mild degrees of inhomogeneity where local pulmonary blood flow (Q) control acts predominantly on the lower VA/Q of the Q distribution, the regulatory effect is best. At severe degrees of inhomogeneity where local Q control acts mainly on the higher VA/Q of the Q distribution, the regulatory effect is worse, and positive-feedback behavior may occur. Local Q control has the potential of reducing the deleterious effects of lung disease on pulmonary gas exchange particularly when it operates in association with other regulatory mechanisms.