Dead space is the portion of each tidal volume that does not take part in gas exchange.
There are two different ways to define dead space-- anatomic and physiologic. Anatomic dead space is the total volume of the conducting airways from the nose or mouth down to the level of the terminal bronchioles, and is about 150 ml on the average in humans. The anatomic dead space fills with inspired air at the end of each inspiration, but this air is exhaled unchanged. Thus, assuming a normal tidal volume of 500 ml, about 30% of this air is "wasted" in the sense that it does not participate in gas exchange.
Physiologic dead space includes all the non-respiratory parts of the bronchial tree included in anatomic dead space, but also factors in alveoli which are well-ventilated but poorly perfused and are therefore less efficient at exchanging gas with the blood. Because atmospheric PCO2 is practically zero, all the CO2 expiredin a breath can be assumed to come from the communicating alveoli and none from the dead space. By measuring the PCO2 in the communicating alveoli (which is the same as that in the arterial blood) and the PCO2 in the expired air, one can use the Bohr Equation to compute the "diluting," non-CO2 containing volume, the physiologic dead space.
In healthy individuals, the anatomic and physiologic dead spaces are roughly equivalent, since all areas of the lung are well perfused. However, in disease states where portions of the lung are poorly perfused, the physiologic dead space may be considerably larger than the anatomic dead space. Hence, physiologic dead space is a more clinically useful concept than is anatomic dead space.
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