DECREASED PULMONARY DISTENSIBILITY AND PULMONARY BAROTRAUMA IN DIVERS

Pulmonary distensibility, lung volume and conductance were measured in 14 men (mean age 22 (SD 3) years) who suffered pulmonary barotrauma (PBT) during shallow water diving. Exponential analysis of static pressure-volume data obtained during deflation of the lungs gave K, an index of distensibility. The pulmonary conductance-recoil pressure (G(L)-P(L)) relationship was also obtained during deflation. Total lung capacity (TLC) was measured in a body plethysmograph or by nitrogen washout. The results were compared with 34 male nonsmokers and 10 healthy male divers. Mean lung volumes and FEV1 did not differ significantly in the three groups. In the PBT group K was decreased and recoil pressure was increased; the slope of the regression of G(L) on P(L) was decreased indicating stiffer airways. Decreased K reflects a decreased airspace size. Smaller airspaces increase the surface component of recoil pressure which increases the stress in tissue fibres. Relatively stiff airways may magnify the elastic stresses in peribronchial alveolar tissue increasing the possibility of rupture of alveolar walls with interstitial gas dissection.