Contribution of Bronchopleural Gas Leak, After Resection of Emphysematous Bullae, CO₂ Excretion

¹ Director, "Centro Rehabilitación Respiratoria."
² Chief of Staff, "Centro Rehabilitación Respiratoria."
³ Chief of Anesthesia Department, "Centro Rehabilitación Respiratoria."

Patients with large emphysematous bullae were subjected to surgical resection while breathing was maintained by a positive pressure, constant volume respirator. In some of them expired volume was seen to drop markedly when inspiratory gas leak through the sutures of bullae developed. Gas coming through that fistula was found to be rich in CO₂, thus contributing to alveolar ventilation. We believe that alveolar expired air, remaining in the conducting airway, and pushed through a lesser resistance pathway may be the source of CO₂ found in the collected gas leak. This fact should not be neglected when ventilation is artificially regulated in these patients.