Hospital of The Rockefeller Institute for Medical Research.
J Exp Med. 1923 Sep 30;38(4):445-76. doi: 10.1084/jem.38.4.445.
The lung volumes in a group of individuals suffering from chronic cardiac disease have been studied by a method which is applicable to patients suffering from dyspnea. In a number of instances the same patients were investigated during various stages of decompensation and compensation. The values found have been compared with those determined in a group of normal subjects. Lung volumes have been considered from three points of view: (1) relative lung volumes or subdivisions of total lung volume expressed as percentage of total lung volume; (2) the absolute lung volumes of patients with heart disease have been compared with lung volumes calculated for normal individuals having similar surface areas or chest measurements; and (3) in individual cases absolute lung volumes have been measured in various stages of compensation and decompensation. (1) In patients with heart disease it has been observed that the vital capacity forms a portion of the total lung volume relatively smaller than in normal individuals, and that the mid-capacity and residual air form relatively larger portions. When the patient progresses from the compensated to the decompensated state these changes become more pronounced. (2) When the absolute lung volumes determined for patients are compared with volumes of the same sort, as calculated for normal individuals of the same surface areas and chest measurements, the following differences are found. The vital capacities are always smaller in the patients and the volumes of residual air are always larger. There is a tendency for middle capacity and total capacity to be smaller, though, when the patients are in a compensated state, these volumes may approximate normal. (3) When decompensation occurs the absolute lung volumes undergo changes as follows: (a) vital capacity, mid-capacity, and total capacity decrease in volume; and (b) the residual air may either increase or decrease according to the severity of the state of decompensation. The significance of these changes has been discussed and an explanation offered for the occurrence of a residual air of normal volume in patients with heart disease. It results from a combination of two tendencies working in opposite directions: one to increase the residual air-stiffness of the lungs (Lungenstarre); the other to decrease it-distended capillaries (Lungenschwellung), edema, round cell infiltration.
一组患有慢性心脏病的个体的肺容积通过一种适用于呼吸困难患者的方法进行了研究。在许多情况下，同一组患者在不同的失代偿和代偿阶段进行了调查。所得到的值与一组正常受试者的确定值进行了比较。肺容积从三个方面进行了考虑：(1)相对肺容积或总肺容积的细分，以总肺容积的百分比表示；(2)心脏病患者的绝对肺容积与具有相似表面积或胸部测量值的正常个体计算的肺容积进行了比较；(3)在个别情况下，在各种代偿和失代偿阶段测量了绝对肺容积。(1)在心脏病患者中，观察到肺活量形成总肺容积的一部分，相对于正常个体较小，而中容量和残气形成相对较大的部分。当患者从代偿状态进展到失代偿状态时，这些变化变得更加明显。(2)当为患者确定的绝对肺容积与相同类型的容积进行比较时，与相同表面积和胸部测量值的正常个体计算的容积进行比较，发现了以下差异。肺活量总是较小，残气量总是较大。中容量和总容量也有较小的趋势，尽管当患者处于代偿状态时，这些容量可能接近正常。(3)当失代偿发生时，绝对肺容积会发生以下变化：(a)肺活量、中容量和总容量的体积减少；(b)残气量可能会根据失代偿状态的严重程度增加或减少。已经讨论了这些变化的意义，并为心脏病患者正常残气量的发生提供了解释。这是两种相反趋势共同作用的结果：一种是增加肺僵硬度（肺僵硬）的残余空气；另一种是减少它的扩张毛细血管（肺肿胀）、水肿、圆形细胞浸润。
