[Pulmonary hypertension in patients with emphysema].

Fifty-three patients with chronic and stabilized emphysema, mostly of the panlobular type, and without any associated disease likely to interfere with the cardio-pulmonary function, were used to analyze the physiological factors responsible for their pulmonary hypertension, moderate at rest but marked at exercise. The study showed that the main responsibility for pulmonary hypertension, both at rest and during exercise, lay on mechanical respiratory factors and on passive regulation of the lesser circulation. It also showed that the predictive value of SaO2 was higher than that of PaO2 but lower than that of CvO2 which depends on a relative tissue hypoxia of cardiovascular origin responsible for vasoconstrictive acidosis at exercise.

[Gas exchanges on effort in diffuse pulmonary emphysema (author's transl)].

With the aim of determining the causes of hypoxia which develops on effort in certain emphysema sufferers, gas exchange at rest and effort were studied in 28 patients with diffuse pulmonary emphysema (including one third with large bullous form), with the exclusion of any clinical evidence of bronchitis or asthma. These patients, selected on the basis of the similarity of their clinical, radiological, mechano-spirographic and diffusion criteria, behaved very differently in terms of their gas exchanges during a moderate effort (mean VO2 = 750 ml/mn). The first group of 12 subjects showed a significant fall in pO2 (- 10.

[Clinical and physiological post-operative course of 45 bullous emphysema (author's transl)].

45 patients exhibiting a diffuse emphysema associated with voluminous emphysematous bullae underwent surgical resection of the bullae. They were then regularly followed-up. Pulmonary function investigations were performed preoperatively in 38 patients at 6 months, 1 year and 3-7 years after resection.