Restrictive Lung Disease and Pneumothoraces
RLD is characterized by a limitation of lung expansion; the hallmark of the condition is decreased total lung capacity (TLC) below the fifth percentile of the predicted value .
This results in decreased functional residual capacity (FRC), increased work of breathing, and often hypoxemia.
Reduced forced expiratory volume (FEV1) and forced vital capacity (FVC) (with normal or elevated ratio) are characteristic findings.
RLD may result from  pathology of the parenchyma itself (e.g., idiopathic pulmonary fibrosis, granulomatous disease, scleroderma, systemic lupus erythematosus),  neuromuscular disease (e.g., myasthenia gravis, amyotrophic lateral sclerosis), or  structural abnormality (e.g., kyphoscoliosis, morbid obesity).
The diffusion capacity of carbon monoxide (DLCO) differentiates intrinsic lung disease (decreased DLCO) from extrapulmonary causes (normal DLCO).
Patients with intrinsic parenchymal disease and pulmonary fibrosis may also have secondary pulmonary hypertension, which carries a significantly higher morbidity and mortality .
TLC is used to classify RLD as mild (65–80% predicted value), moderate (50–65%), or severe (less than 50%).
KeywordsRestrictive lung disease Total lung capacity Functional residual capacity Minute ventilation Pulmonary function testing Primary spontaneous pneumothorax Pregnancy Neuraxial anesthesia
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