Effect of removal of bullae on airway conductance and conductance volume ratios.

Airway conductance is known to increase with an increase in the lung volume at which it is measured, owing to a change in transpulmonary pressure and lung tissue tension. We investigated the effect of surgical resection of lung tissue on functional residual capacity and airway conductance in patients with localized lung disease (i.e., carcinoma or tuberculosis) and in patients with lung cysts or bullous emphysema. In four out of five of the patients who had resection of one or more lobes of the lung to remove localized disease there was a reduction both in the airway conductance and in the functional residual capacity with relatively little change in the conductance volume ratio. By contrast, in all patients who underwent bullectomy, there was a decrease in functional residual capacity but an increase in airway conductance, and an increase in the conductance/volume ratio. This change was sustained in patients who had had localized cysts removed. However, the measurements gradually reverted toward preoperative values in those patients who had generalized emphysema. The increase in airway conductance after resection of blebs and bullae presumably was due to improved lung elastic pressure causing the airways to increase in diameter and conductance. In addition, some patients may have experienced relief of compression of neighboring airways.