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The air blood barrier phenotype can be reasonably described by the ratio of lung capillary blood volume to the diffusion capacity of the alveolar membrane ( Vc/Dm ), which can be determined at rest in normoxia. The distribution of the  Vc/Dm  ratio in the population is normal;  Vc/Dm  shifts from ∼1, reflecting a higher number of alveoli of smaller radius, providing a high alveolar surface and a limited extension of the capillary network, to just opposite features on increasing  Vc/Dm  up to ∼6. We studied the kinetics of alveolar-capillary equilibration on exposure to edemagenic conditions (work at ∼60% maximum aerobic power) in hypoxia (HA) (P I O 2  90 mmHg), based on an estimate of time constant of equilibration (τ) and blood capillary transit time ( Tt ). A shunt-like effect was described for subjects having a high  Vc/Dm  ratio, reflecting a longer τ (&amp;gt;0.5 s) and a shorter  Tt  (&amp;lt;0.8 s) due to pulmonary vasoconstriction and a larger increase in cardiac output (&amp;gt;3-fold). The tendency to develop lung edema in edemagenic conditions (work in HA) was found to be directly proportional to the value of  Vc/Dm  as suggested by an estimate of the mechanical properties of the respiratory system with the forced frequency oscillation technique.

Role of the Air-Blood Barrier Phenotype in Lung Oxygen Uptake and Control of Extravascular Water