Recognition of Early Emphysema by Pulmonary Function Tests

¹ The Department of Medicine, University of Wisconsin Medical School and the Veterans Administration Hospital.

One hundred and fifty tuberculous patients received pulmonary ventilatory tests prior to lobectomy for removal of residual disease or cavity. Patients were selected whose removed specimen yielded an "ideal biopsy" of the lung. The presence or absence of chronic obstructive emphysema was determined on the basis of gross inspection of the cut lung. The most sensitive indication of early emphysema was a combination of positive findings on all three ventilatory tests, TVC of 90 per cent or less, elevation of the MBC spirogram to hyperinflation level and single breath O₂, test of 2 per cent or greater. It was possible to predict correctly whether or not generalized emphysema was present in 93 per cent of the patients examined. A follow-up study on 94 of these patients showed no significant reversibility of the three ventilatory screening tests within an average period of six months postoperative. Only six patients appeared to develop emphysema within the six months following lobectomy.