Abstract
To the Editor:— article Pulmonary-Function Tests which appeared inThe Journal( 206 :2302, 1968) contains the following statement: The level of arterial Pco 2 is governed solely by the alveolar ventilation. Elevated Pco 2 means alveolar hypoventilation, and reduced Pco 2 , alveolar hyperventilation. Such a statement ignores the ventilation to perfusion relationship in which a reduction in perfusion may commonly increase functional dead space, shuntlike effects, hypoxemia, and finally CO 2 retention. Ventilation-perfusion problems must be distinguished from alveolar hypoventilation, which caused decreased alveolar Po 2 together with increased arterial Pco 2 . While it is true that a diffusion barrier for CO 2 is for practical purposes almost nonexistent as compared to O 2 , the perfusion of alveoli has an important role in relationship to CO 2 elimination. This fact has clinical importance in the evaluation of pulmonary emboli in which the alveolar Pco 2 levels may be reduced
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