Compliance of the chest wall in chronic bronchitis and emphysema

¹ Department of Medicine, University of Manitoba and the Winnipeg General Hospital, Winnipeg, Canada

The respiratory rate was found to be faster and the tidal volume lower than normal in patients with chronic bronchitis and emphysema. The compliance of the total respiratory system, the lungs, and the chest wall was measured in 11 normal subjects and 13 patients with chronic bronchitis, 11 of whom had also developed emphysema. The compliance of the total respiratory system was lower than in the normals in the patients with chronic bronchitis. This was entirely attributable to a reduction in the compliance of the chest wall, that of the lungs being similar to that of the normals. The vital capacity appeared to be related to the compliance of the total respiratory system and was reduced in the patients with chronic bronchitis and emphysema largely because of a diminished distensibility of the chest wall. It is suggested that the low chest wall compliance may explain the paradoxical finding of rapid shallow respirations in these patients with airway obstruction who theoretically would have been expected to breathe slowly and deeply. It is further suggested that the diminished distensibility of the chest wall in patients with chronic bronchitis and emphysema would necessitate an increase in the amount of work done in order to breathe and, therefore, likely contributes to the disability in this disease.