LEADER
Pulmonary capillaries
Vulnerability of pulmonary capillaries during severe exercise
Correspondence to:
Correspondence to:
Dr John B West
Department of Medicine 0623A, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0623, USA; jwest@ucsd.edu
Accepted 20 July 2006
The pulmonary capillaries are vulnerable to mechanical failure during strenuous exercise
Keywords: pulmonary capillaries; pulmonary haemorrhage; strenuous exercise
| The first 150 words of the full text of this article appear below. |
It is remarkable that it has taken so long to recognise how vulnerable the pulmonary capillaries are to mechanical failure during strenuous exercise. After all, the extreme thinness of the capillary wall was appreciated when the first electron micrographs were obtained by Low in 1952. We now know that the total area of the blood-gas barrier (BGB) in the human lung is 50–100 m2 and that for more than half of this enormous area the thickness is only 0.2–0.3 µm.1 The result is that during severe exercise when the pulmonary vascular pressures rise to high levels, the capillary wall stresses become extremely high approaching the breaking stress of collagen.2 It is not surprising therefore that changes in the integrity of the BGB occur under these conditions.
Perhaps investigators were initially misled by early data from cardiac catheterisation procedures which suggested that pulmonary vascular pressures did not increase during
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