Estimating alveolar surface area during life.

Alveolar surface area (Sa) may be derived from measurements of total lung capacity (TLC) and mean linear intercept (Lm), an estimate of average airspace size. Because the index of pulmonary distensibility, K, is a function of Lm, we were able to derive Lm from ln K using their respective age regressions and estimated Sa in 147 healthy subjects. K was obtained from exponential analysis of static pressure-volume data. TLC was measured in a body plethysmograph. As an estimate of airspace size, the value used for Lm was shown to be appropriate for the air-inflated lung at TLC. In 95 men (mean age 40 +/- 16 SD years), Sa was 118 (SD 22) m2 and in 52 women (mean age 38 +/- 17 SD years) it was 91 (SD 18) m2 and Sa decreased with age (P less than 0.001). In a morphometric study, Thurlbeck (Am. Rev. Respir. Dis. 95: 765-773, 1967) obtained smaller values for Sa (owing to the use of a smaller lung volume) and a similar decrease in Sa with age as that found here. Providing a standardised methodology is used for measurement of K, the present method allows a reasonable estimate of Sa to be obtained during life.