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- W4247825738 abstract "In their classic studies of the patterns of abnormality of lung function in disease, Baldwin et al.1 identified a group of patients with ‘pulmonary insufficiency’ characterised by small lung volumes with no evidence of airflow obstruction. The more severely affected patients showed arterial hypoxaemia which worsened on exercise, but intrapulmonary gas mixing assessed by the 7-minute nitrogen washout test appeared normal. The combination was recognised as characteristic of diffuse alveolar disease and their patients showed radiographic evidence of pulmonary fibrosis. It seemed likely at that time that the basic defect of gas exchange was impairment of oxygen diffusion, and the alveolar wall thickening demonstrable histologically led Austrian et al.2 to coin the term ‘alveolar capillary block syndrome’. This unfortunately encouraged the mental image of a physical barrier between air and blood impeding uptake of oxygen, which persisted until the important calculations of Finley et al.3 showed that very much greater thickening of the alveolar-capillary membrane would be necessary for a significant gradient of PO2 to develop between the alveoli and the distal end of the pulmonary capillaries. They therefore argued that the hypoxaemia was the result of mismatching of ventilation and perfusion. This does not mean that the diffusing capacity of the alveolar-capillary membrane is not reduced — merely that the requirements for diffusion of oxygen remain well within the capacity available. In a similar way the main mechanical abnormality in pulmonary fibrosis — increased stiffness or reduced compliance of the lungs — may convey a simple image of uniform thickening of alveolar walls, but, as discussed below, this picture does not receive support from pathological studies." @default.
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- W4247825738 date "1984-01-01" @default.
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- W4247825738 title "Alveolar diseases" @default.
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- W4247825738 doi "https://doi.org/10.1007/978-1-349-81333-9_8" @default.
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