The physiology of small airways
The physiology of small airways
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DOI：
10.1164/ajrccm.157.5.rsaa-2
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发表时间：
1998-05-01
影响因子：
24.7
通讯作者：
Macklem, PT
中科院分区：
文献类型：
--
作者：
Macklem, PT
In asthma, the involvement of airways from the glottis to the alveolar ducts is likely, and the site of this involvement determines the resulting pathophysiology. The small airways of less than 2 mm in diameter are pathways of low resistance and normally contribute about 10% of the total resistance to flow (1, 2). They are reportedly more resistant in the first few years of life (3), but experiments showing this have not been repeated, so that idea has neither been confirmed nor denied. Confirmation of these results would be an important advance, because if the small airways are high-resistance pathways in infancy, then bronchiolitis would be a much more serious condition in infants than in adults. Hogg and colleagues claimed that this was the reason that acute bronchiolitis was a serious disease in infants but apparently not in adults (3). If one-half of all small airways became completely obstructed, their combined resistance would double. However, the large airways would remain unobstructed and their resistance would not change. If small-airway resistance is only 10% of the total, doubling it would only increase total resistance by 10%. Thus it is difficult to detect small airway obstruction by the usual lung function tests.
