Pulmonary function in nonsmoking chronic alcoholics

To our knowledge, this is the first published report to describe pulmonary function in nonsmoking alcoholics who also do not have a history of respiratory illness. This study, in sharp contrast to those that include smokers, shows that pulmonary function, including diffusing capacity, is within normal limits. The "true shunt" noted in all subjects who underwent blood gas studies is probably related to liver disease. Our study also suggests that gas exchange may be impaired even in patients with mild alcoholic liver disease (table 3). When the airway closes prematurely as a result of blood vessel dilatation and/or interstitial pulmonary edema, ventilation decreases. This results in appreciable shunting via portopulmonary and intrapulmonary communications and in a very low ventilation/perfusion ratio of the dependent lung zones. We consider that application of any formula to separate the effects of tobacco from those of alcohol will produce, at best, approximate values.