The pulmonary system, also known as the respiratory system, allows us to breathe by bringing oxygen into the body and removing carbon dioxide. It includes the lungs, airways, blood vessels, and respiratory muscles. The lungs contain millions of alveoli where gas exchange occurs between the blood and air. Lung diseases such as asthma, COPD, and lung cancer can damage the lungs and impair their ability to oxygenate the blood and remove carbon dioxide, potentially leading to hypoxia, hypercapnia, and other health issues. Lung transplantation and artificial lungs can provide life-saving treatment for patients with end-stage lung disease.
2. The pulmonary system, also known as the respiratory
system, is the network of organs and tissues that allow
us to breathe. It is responsible for bringing oxygen into
the body and removing carbon dioxide, a waste product.
This process is essential for maintaining life.
Components
Lungs: Two spongy organs located in the chest that
contain millions of tiny air sacs called alveoli.
Airways: A network of tubes that carry air to and
from the lungs. These include the
trachea, bronchi, and bronchioles.
Respiratory muscles: Muscles that help us
breathe, including the diaphragm and intercostal
muscles.
Blood vessels: Carry oxygen-rich blood from the lungs
to the rest of the body and carbon dioxide-rich blood
from the rest of the body to the lungs.
The pulmonary system
3. Inspiration: When we inhale, the diaphragm and
intercostal muscles contract, expanding the chest
cavity. This creates a low-pressure area in the
lungs, drawing air into the airways and alveoli.
Gas Exchange: In the alveoli, oxygen from the air
crosses the thin membrane into the blood, while carbon
dioxide from the blood moves across the membrane
into the air.
Expiration: When we exhale, the diaphragm and
intercostal muscles relax, causing the chest cavity to
shrink. This forces air out of the lungs and airways.
Regulation of blood pH: The lungs play a role in
maintaining the acid-base balance of the blood by
removing carbon dioxide, an acidic gas.
Production of immune cells: The lungs produce
immune cells that help to protect the body from
infection.
Regulation of body temperature: The lungs help to
regulate body temperature by releasing heat through
the exhalation of air.
Function:
4. Oxygen delivery: The lungs are responsible for absorbing
oxygen from the air and delivering it to the
bloodstream. Oxygen is essential for all bodily
functions, including energy production, cell growth, and tissue
repair. Without adequate oxygen, the body's organs would
begin to shut down.
Carbon dioxide removal: The lungs also remove carbon
dioxide, a waste product of cellular respiration, from the blood
and expel it into the air. Carbon dioxide build-up can lead to
acidosis, which can be fatal.
Regulation of blood pH: The lungs play a vital role in regulating
the body's acid-base balance by removing carbon dioxide, an
acidic gas. This helps maintain the optimal pH range for
important biological processes.
Immune function: The lungs produce and release immune cells
that help defend the body against infections. These cells help to
clear bacteria, viruses, and other pathogens from the
respiratory tract.
Regulation of body temperature: The lungs help to regulate
body temperature by releasing heat through the exhalation of
air. This helps to prevent the body from overheating during
exercise or hot weather.
Importance of the Pulmonary System:
5. Lung Diseases
1. Asthma:
Chronic inflammatory condition: The airways become
inflamed and hyperresponsive, leading to episodes of
wheezing, shortness of breath, chest tightness, and
coughing.
Triggers: Allergens, dust mites, air pollution, exercise,
respiratory infections.
Treatment: Bronchodilators (to open airways),
corticosteroids (to reduce inflammation), allergy
management, and avoiding triggers.
2. Chronic Obstructive Pulmonary Disease (COPD):
Progressive lung disease: Causes airflow limitation due to
damaged airways and alveoli.
Symptoms: Shortness of breath, chronic cough with
phlegm, wheezing, fatigue.
Causes: Long-term exposure to cigarette smoke is the
leading cause, also air pollution, occupational hazards,
and genetics.
Treatment: Bronchodilators, corticosteroids, oxygen
therapy, pulmonary rehabilitation, and smoking
cessation.
6. 3. Interstitial Lung Disease (ILD):
Group of lung diseases: Cause scarring and
thickening of the lung tissue, impairing gas exchange.
Symptoms: Shortness of breath, dry cough, fatigue,
weight loss, chest pain.
Causes: Diverse, including autoimmune diseases,
exposure to toxins, and idiopathic (unknown) causes.
Treatment: Varies depending on the specific ILD, may
include corticosteroids, immunosuppressants,
antifibrotic drugs, lung transplantation in severe
cases.
4. Lung Cancer:
Uncontrolled cell growth in the lungs: Can spread to
other parts of the body.
Symptoms: Cough (often with blood), shortness of
breath, chest pain, fatigue, weight loss.
Causes: Smoking is the leading cause, also exposure
to radon gas, air pollution, and family history.
Treatment: Surgery, radiation therapy, chemotherapy,
immunotherapy, targeted therapy.
Lung Diseases
7. Decreased oxygen delivery: Lung diseases can damage the
lungs and airways, making it difficult for them to absorb
oxygen effectively. This can lead to hypoxia, a condition
where the body's cells are deprived of oxygen, resulting in
fatigue, shortness of breath, and impaired cognitive function.
Carbon dioxide retention: In severe lung disease, the ability to
remove carbon dioxide from the blood can be
compromised, leading to hypercapnia, a condition
characterized by increased carbon dioxide levels in the
blood. This can cause drowsiness, confusion, and coma.
Increased risk of infection: Damaged lungs are more
susceptible to infections, as they are less able to clear
bacteria and viruses. This can lead to pneumonia and other
respiratory illnesses.
Pulmonary hypertension: Some lung diseases can cause
pulmonary hypertension, a condition where the blood
pressure in the arteries leading to the lungs is abnormally
high. This can put a strain on the heart and lead to heart
failure.
Reduced quality of life: Lung diseases can significantly
impact a person's quality of life, limiting their ability to
Consequences of Lung Disease:
8. Anatomy of the Lungs
What are your lungs?
Your lungs make up a large part of your respiratory
system, which is the network of organs and tissues that
allow you to breathe.
You have two lungs, one on each side of your chest,
which is also called the thorax. Your thorax is the area
of your body between your neck and your abdomen.
9. Where are your lungs located?
Your lungs are located in your chest (your thorax). Your
thoracic cavity is the name of the space that contains
your lungs and other organs. Your lungs rest on a
muscle called your diaphragm.
What do lungs look like?
Healthy lungs are pinkish-gray in color. Youve probably
seen photographs that compare the lungs of people who
smoke to the lungs of people who dont. Damaged lungs
are darker gray and can have black spots in them.
Your triangularly shaped right and left lungs look a
little bit like the ears of an elephant.
A typical lung in a human adult lung weighs about 2.2
pounds and is a little longer than 9 inches when youre
breathing normally, and about 10.5 inches when your
lungs are completely expanded.
10. Lung transplantation is a complex surgical procedure
that offers a life-saving option for patients with end-
stage lung disease. This procedure involves replacing
diseased or damaged lungs with healthy ones from a
deceased donor.
Lung Transplantation: A Breath of New Life
Procedure:
There are two main types of lung transplantation:
Single lung transplant: This involves replacing one
diseased lung with a healthy donor lung.
Double lung transplant: This involves replacing both
diseased lungs with two healthy donor lungs.
11. 1. General anesthesia: The patient is placed under
general anesthesia to ensure they are unconscious
and pain-free during the surgery.
2. Incision: A large incision is made in the chest to
access the lungs.
3. Removal of diseased lung(s): The diseased lung(s)
are carefully removed.
4. Implantation of donor lung(s): The donor lung(s) are
carefully positioned and connected to the patient's
airways and blood vessels.
5. Closure: The chest is closed, and the patient is
transferred to the intensive care unit for recovery.
The surgical procedure typically involves:
12. Risks and Benefits:
Lung transplantation offers significant benefits for
patients with end-stage lung disease, including:
Improved quality of life
Increased lifespan
Reduced symptoms
Increased ability to perform daily activities
However, lung transplantation also carries significant
risks, including:
Infection
Bleeding
Rejection of the donor lung(s)
Complications from immunosuppressive medications
13. Lung transplantation success rates have improved
significantly in recent years. According to the Organ
Procurement and Transplantation Network (OPTN),
the 1-year survival rate for lung transplant recipients
is approximately 85%, and the 5-year survival rate is
approximately 65%. These rates vary depending on
various factors, including the patient's age, overall
health, and type of transplant performed.
Success Rates:
14. Artificial Lungs: A Life-Saving Technology
When the lungs are severely damaged and unable to
adequately perform their vital function of gas exchange,
artificial lungs can provide life-saving support. These
devices take over the work of the lungs, allowing the
body to receive the oxygen it needs while removing
harmful carbon dioxide.
There are two main types of artificial lungs:
1. Extracorporeal Membrane Oxygenation (ECMO):
ECMO is a complex system that removes blood
from the body, removes carbon dioxide and adds
oxygen, and then returns the blood to the body.
It is primarily used for critically ill patients who
have suffered severe heart or lung failure and
require temporary support while awaiting recovery
or organ transplantation.
ECMO can be used for both adults and children.
Types of Artificial Lungs:
15. Oxygenator: The oxygenator is a crucial part that
performs roles like a gas exchange, taking in oxygen
from an external source, and expulsion of carbon
dioxide from the patient's blood. It comprises a series of
hollow fibers or membranes through which gas and
blood flow in counter-current directions, which allows
for the efficient transfer of oxygen and carbon dioxide
across the membrane.
What Are The Parts Of The Artificial Lungs?
Pump: Artificial lungs consist of a pump to circulate the
patient's blood through the system. The pump is
responsible for maintaining adequate blood flow and
pressure, ensuring oxygenated blood is delivered to the
patient's body. Several categories of pumps can be used,
like centrifugal pumps or roller pumps.
16. Cannulas: These are tubes that enhance the
connection between the patient's blood vessels and
the artificial lung system. Cannulas are mostly
inserted into major blood vessels, like the jugular
vein or femoral artery and vein, to facilitate the flow
of blood to and from the system.
Filters: Filters are incorporated into the artificial
lung system to expel any potential clots or debris
from the blood. These filters are helpful to ensure
the system remains free of blockages and prevent
any adverse effects on the patient.
17. Heat Exchange: To sustain the temperature of the
blood, artificial lungs often incorporate a heat
exchanger. These components are helpful to warm or
cool the blood as necessary, ensuring it remains
within the desired temperature range.
Tubing and Connectors: Various tubing and
connectors are utilized to establish the necessary
connections between the different components of the
artificial lung system, including the oxygenator,
pump, cannulas, and filters.
18. There are two main types of artificial lungs:
1. Extracorporeal Membrane Oxygenation (ECMO):
ECMO is a complex system that removes blood
from the body, removes carbon dioxide and adds
oxygen, and then returns the blood to the body.
It is primarily used for critically ill patients who
have suffered severe heart or lung failure and
require temporary support while awaiting recovery
or organ transplantation.
ECMO can be used for both adults and children.
19. What does ECMO stand for?
ECMO stands for extracorporeal membrane
oxygenation. Extracorporeal means outside the
body. The rest of the name refers to getting oxygen
to your bodys cells.
How does ECMO work?
During ECMO treatment, blood flows out of your
body through a tube in a large blood vessel in your
chest, near your groin or in your neck. A pump
pushes your blood through tubes that carry it to a
machine that adds oxygen and removes carbon
dioxide. Then the machine pumps your blood back
into your body.
ECMO treatment helps people who need support for
their lungs, but it can also bypass both your heart
and lungs.
20. Mechanical ventilation is a form of life support that helps you
breathe (ventilate) when you cant breathe on your own. This can
be during surgery or when youre very sick.
While mechanical ventilation doesnt directly treat illnesses, it can
stabilize you while other treatments and medications help your
body recover.
Ventilators are machines that help patients breathe by
mechanically pushing air into and out of their lungs.
They are commonly used for patients who are unable to breathe
on their own due to various conditions, including
paralysis, neuromuscular diseases, and respiratory failure.
Ventilators come in various types, including invasive (requiring
a tube inserted into the airway) and non-invasive (using a mask
to deliver air).
2. Artificial Ventilators:
21. Modern mechanical ventilators use positive pressure to
push air into your lungs. Positive pressure ventilation can
be invasive or noninvasive.
Invasive mechanical ventilation: This means you have a
tube in your airway connected to a ventilator. This tube
can go through your mouth (intubation) or neck
(tracheostomy).
Noninvasive ventilation: This uses a face mask
connected to a ventilator. Straps hold the mask to your
head to hold it tight. The ventilator pushes air into your
lungs. Forms of noninvasive ventilation include devices
you might use at home, like CPAP or BiLevel positive
airway pressure (often known under the trade name
BiPAP速).
What are the types of mechanical ventilation?
22. The length of time you need mechanical
ventilation depends on the reason. It could be
hours, days, weeks, or rarely months or
years. Ideally, youll only stay on a ventilator
for as little time as possible. Your providers
will test your ability to breathe unassisted
daily or more often.
In general, if you need to be on a ventilator
for a long time (2 weeks or so), a provider will
switch you from an endotracheal tube to a
tube in your neck (tracheostomy).
How long can you be kept on a ventilator?
23. To start invasive mechanical ventilation, a provider will:
1. Give you medication to relax you (sedation) and to prevent
you from moving (paralytic). Youll most likely remain
sedated, but the paralytic will wear off after youre on the
ventilator.
2. Place an endotracheal (ET) tube down your throat and
trachea (airway leading to your lungs).
3. Attach the tube to a ventilator. The ventilator will help you
breathe until your medical team feels its safe for you to
breathe on your own again.
These are the general steps for starting mechanical ventilation.
Depending on your specific situation, especially whether or not
its an emergency, some of these steps may be a little bit
different.
How is someone placed on invasive mechanical
ventilation?
24. Uses:
ECMO and ventilators are crucial in treating
various conditions, including:
Severe pneumonia
Acute respiratory distress syndrome
(ARDS)
Chronic obstructive pulmonary disease
(COPD) exacerbations
Cardiopulmonary bypass during surgery
Drug overdose
Trauma
Limitations:
Artificial lungs are complex and expensive to
operate.
They require specialized medical personnel to
manage and monitor.
They can lead to complications, including
infections, bleeding, and blood clots.
They are not a cure for lung disease and are
intended for temporary support while the
underlying issue is addressed.
Uses and Limitations:
25. Researchers are constantly working to improve
artificial lung technology. Some promising areas of
development include:
Miniaturization: Making artificial lungs smaller and
more portable.
Improved biocompatibility: Reducing the risk of
complications such as infections and blood clots.
Lung assist devices: Developing implantable devices
that can support the lungs in patients with chronic
lung disease.
Future Developments: