Can someone explain collateral ventilation in simple terms please. thank you davy

[davy1192]

[phillips1]

Hi Davey and welcome. That is some question you have asked there. As I understand it when the usual pathways for air become blocked the body finds other routes through the lungs to get the air to where it needs to go. I think you need a degree in medicine to fully understand it. Sorry I can't be of more help.

Bobby

[Hidden]

Welcome Davy

I'm sorry I can't be of any help to you, I'm sure someone will be along that can help with this question.

Take care

Peta

[scrobbitty]

I reckon this is ideal question to put to the BLF Helpline Team - 03000 030 555 Hope you get the answers you need xx

[libbygood]

Never heard of it so I'm no help, hope someone comes along who knows.

Lib x

[johnwr]

Hello Davy,

Let's see if I can help explain this for you. It may be a bit long-winded, so please bear with me.

In the lungs of a normal, healthy person, there is one single route inwards and out again for each of the alveoli (alveoli are the tiny cavities at the end of the airways where the gas exchange with the blood happens). Think in terms of a bunch of grapes. Alveoli are the grapes, the airways are the stalks.

When the lungs get damaged, whether through disease or pollution or irritation, if the membrane suffers extensive damage, then some of that membrane is replaced, as part of the healing process, with scar tissue. If there are repeated episodes of disease, or sustained exposure to pollution or other causes of irritation, then the amount of scarring can become significant.

Scar tissue is not as elastic as the original membrane. It also does not permit gas exchange. As our lungs expand and contract, if the sites where scarring has occurred have become a significant size, then some tearing can happen. This tearing is minute, and is no cause for concern in terms of day to day wear and tear. It is the long term combined effect over years that is the problem. This is where we now jump to, several year down the line. Imagine that two adjacent alveoli have a lot of scarring, and another inflaming infection takes hold, and one particular breath is deeper and heavier than normal, and it causes a tear that goes through the tissue between the alveoli. You now have a hole that will not close. The tissue will heal, but leaves an enlarged cavity because that requires less stretching than the original formation. For the bunch of grapes, two grapes have been replaced by one damson fed by two stalks. After several more years, a number of damsons have formed, and some of those have merged into much larger plums. This is now advanced Emphysema, with some large cavities (called bullae), and we are at the point where medical intervention is required. One of the things that has to be considered to determine which operation is best to go for is how this damage presents itself.

The structure of the lungs is that they are divided into zones called lobes, three in the right, and two in the left. Thinking in terms of the bunches of grapes, consider that each lobe is home to one complete bunch whose only contact normally is through the main stem (the main airway). If the damage within the lungs is confined within the individual bunches, in other words, does not cross the boundaries between the lobes, then there is no colateral ventilation. Colateral ventilation occurs when the the tissue damage permits the passage of air between the lobes through holes between the lobes.

As the damage progresses, as the cavities form, so the internal support structure of the lungs gets reduced. This allows the lungs to become longer and they over inflate because of the loss of elasticity. They sit on the diaphragm, the bottom lobe of each lung gets compressed and generally cannot continue to work properly. The diaphragm now has to lift this extra weight with each breath taken. Through a day, that adds up to a lot of extra hard work. Taken with the loss of alveoli, and the presence of frequent infections etc, the lungs are now operating at maybe as low as 15% of their full capability when in good condition. The patient is permanently fatigued and needs lots of medication to keep the airways open. Often oxygen is needed. At this point, the consultant decides that surgical intervention is required. The first choice at the moment for most consultants is to use pulmonary valves. They are easy to fit, they allow the blocked off part of the lung to continue to pass CO2 and the lungs natural secretions out. Most importantly, they are reversible (if need be, they can be removed easily). The biggest deciding factor in choice for or against valves is whether or not there is colateral ventilation. If there is none, or is very minor, then valves could be considered. If there is colateral ventilation, then the usual decision is to go for lung reduction surgery.

As you can see, at the stage where there needs to be a choice made, the presence or not of colateral ventilation is important. Links to some videos that may help follow:

pulmonx.com/en/downloads/vi...

pulmonx.com/en/downloads/vi...

Hope this helps you, Davy,

breathe easy

johnwr

[davy1192 in reply to johnwr]

Thanks John

valves is what am hoping to get.

davy

[johnwr in reply to davy1192]

Davy,

I had valves in Feb last year. Fantastic result for me. I've written several blogs about my experiences. Follow the links below:

blf.healthunlocked.com/blog...

blf.healthunlocked.com/blog...

healthunlocked.com/!/#blf/p...

I'll answer any questions you might have.

BTW which hospital are you being seen at?

all the best

johnwr

[appyalison in reply to johnwr]

Woah, John, fair play, brilliant!! Alison

[davy1192 in reply to johnwr]

At this time I would not like to say which hospital, till everything is in place hope you understand.

davy

[johnwr in reply to davy1192]

Not a problem, I understand you not wanting to tempt fate.

johnwr

[Toci in reply to johnwr]

johnwr = awesome!!

[Jemma in reply to johnwr]

Johnwr Many thanks for another great post

[Tamara70 in reply to johnwr]

Hi JohnWr

A great answer! I thought there was some hope for me with insertion of pulmonary valves until I came to the end of your article and saw that

Lung surgery was the end result. Unfortunately, I have had two lobes

removed so if they take out any more that will be when I am on the way to six feet under!

Tamara

[Offcut in reply to johnwr]

Great description

I was in ICU for 32 days of which I was on a Oscillator for 12 days and they told me that I had a lot of scaring because of the infection and the fact that they inflated my lungs to the max. I have ongoing fibrosis, pleurisy compacted by a paralysed right diaphragm. I am fatigued all of the time and have pain on deep breaths. This all happened 5 years ago I have not improved and getting worse year on year.

[davy1192]

Thank you all for your answers,

davy

[martin1945]

Collateral Ventilation is sometime referred to as "Leaky Lung Syndrome" . I attempted to have EBVs implanted but due to collateral ventilation they were not successful and had to be removed. Ho! Hum!

[johnwr in reply to martin1945]

Hello Martin,

So sorry to hear of your misfortune. I hope they manage to come up with another answer for you. Perhaps coils????

breathe easy, Martin.

johnwr