Quantification of regional ventilation in humans using a short-lived radiotracer--theoretical evaluation of the steady-state model

The accuracy of the steady-state measurement of ventilation by means of a short-lived insoluble inert gas tracer rests with the validity of the steady-state flow equation. This has previously been applied to the qualitative assessment of regional ventilation using krypton-81m, but may potentially be used for the calculation of regional alveolar ventilation per unit alveolar gas volume--(VA/VA)cal--from measurements of the alveolar concentration of the tracer. The steady-state alveolar tracer concentration was calculated for the course of a breathing cycle, using a lung model featuring airways dead space and tidal gas flow. The calculations were made by computer simulations of a lung, characterized by predefined values of parameters describing the lung structure and the mode of ventilation. In the normal lung of supine man at rest (specific alveolar ventilation, ranging from 1.0 to 3.5 min-1) the errors of (VA/VA)cal relative to the predefined true values range from an overestimation by some 3% in the low ventilation regions to an underestimation by 8% in the best ventilated regions. The errors mainly result from ventilation of the airways dead space, which will influence the distribution of tracer in the lung by the transfer of tracer between regions by way of the common dead space and by the decay of tracer during its transport through the bronchial tree