Lung Compliance

User Name-Shalini Varadhan

Top Contributors-Shalini Varadhan

Introduction

Lung Compliance is defined as the change in lung volume produced by a unit change in transpulmonary pressure. It is represented by the gradient of the pressure–volume curve.1

Normal Range: The total compliance of both lungs together in normal adult human being average is about 200 milliliters of air per centimeter of water trans-pulmonary pressure. when trans pulmonary pressure increases one centimeter of water the lung volume after 10 to 20 seconds will expand 200 milliliteres.4

Compliance Diagram

The diagram relates the lung volume differs to changes in the trans pulmonary pressure. It differs for inspiration and expiration.

Compliance Curve

The two compliance curves are:

  1. Inspiratory Compliance curve
  2. Expiratory Compliance curve

Types of Compliance

Dynamic Compliance :is defined as the change in lung volume per unit change in pressure in the presence of flow. 

Static Compliance : is defined as the change in lung volume per unit change in pressure in the absence of flow. 

Important Factors

The two important factors of Lung compliance  :

Elastic Fibers : More fibers in the tissue lead to ease in expand-ability and there for compliance.

Surface tension : It is decrease due to the production of surfactant to prevent collapse.4

Hysteresis

Hysteresis is the term used to describe the difference between inspiratory and expiratory compliance. Lung volume at any given pressure during inhalation is less than the lung volume at any given pressure during exhalation.3

Hysteresis is present in both static and dynamic lung compliance curves

Hysteresis develops due to:

  • The effect of surfactant
  • Relaxation of lung tissue
  • Recruitment and derecruitment of alveoli
  • Gas absrption during measurement
  • Differences in expiratory and inspiratory air flow (for dynamic compliance)
Factors which affect compliance can be divided into chest wall factors and lung factors:
Factors which Affect Respiratory Compliance7
Lung compliance Chest wall compliance
Increased  lung compliance
  • Lung surfactant
  • Lung volume: compliance is at its highest at FRC
  • Posture (supine, upright)
  • Loss of lung conective tissue associated with age
  • Emphysema
Increased chest wall compliance
  • Ehler-Dahlos syndrome and other connective tissue diseases
  • Rib resection
  • Cachexia
  • Flail segment rib fractures
  • Open chest (eg clamshell)
Decreased static lung compliance
  • Loss of surfactant (eg. ARDS)
  • Decreased lung elasticity
    • Pulmonary fibrosis
    • Pulmonary oedema
  • Decreased functional lung volume
    • Pneumonectomy or lobectomy
    • Pneumonia
    • Atelectasis
    • Small stature
  • Alveolar derecruitment
  • Alveolar overdistension

Decreased dynamic lung compliance

  • Increased airway resistance (eg. asthma)
  • Increased air flow (increased resp rate)
Decreased chest wall compliance
  • Structural abnormalities
    • Kyphosis / scoliosis
    • Pectus excavatum
    • Circumferential burns
    • Surgical rib fixation
  • Functional abnormalities
    • Muscle spasm, eg. seizure or tetanus
  • Extrathoracic influences on chest/diaphragmatic excursion
    • Obesity
    • Abdominal compartment syndrome
    • Prone position

Related articles

Lung volumes-physiopedia

Spirometry-physiopedia

Lung compliance

References

  1. Iotti, G., & Braschi, A. (1999). Measurements of respiratory mechanics during mechanical ventilation. Rhäzüns, Switzerland: Hamilton Medical Scientific Library.
  2. Harris, R. Scott. "Pressure-volume curves of the respiratory system." Respiratory care 50.1 (2005): 78-99.
  3. Rahn, Hermann, et al. "The pressure-volume diagram of the thorax and lung." American Journal of Physiology-Legacy Content 146.2 (1946): 161-178.
  4. https://www.us.elsevierhealth.com/guyton-and-hall-textbook-of-medical-physiology-9781455770052.html
  5. https://www.ncbi.nlm.nih.gov/books/NBK554517/
  6. https://med.libretexts.org/Bookshelves/Anatomy_and_Physiology/Book%3A_Anatomy_and_Physiology_(Boundless)/21%3A_Respiratory_System/21.6%3A_Factors_Affecting_Pulmonary_Ventilation/21.6B%3A_Factors_Affecting_Pulmonary_Ventilation%3A_Compliance_of_the_Lungs
  7. http://rc.rcjournal.com/content/respcare/50/1/78.full.pdf