Bronchial Circulation

The bronchial circulation is part of the systemic circulation, and it serves the metabolic needs of the large airways and blood vessels. The bronchial circulation does not extend to the respiratory zone, which is served by the pulmonary circulation. Bronchial arteries arise from the aorta and intercostal arteries, and the bronchial circulation returns blood to the heart by two pathways. Bronchial veins from large airways return about half the bronchial blood flow to the right heart via the azygos vein. The other half of the bronchial circulation drains directly into the pulmonary circulation. This adds deoxygenated blood to the oxygenated blood returning to the left heart, and constitutes an anatomic shunt. Blood flow through the bronchial circulation is only 1-2% of cardiac output in normal individuals, so this anatomic shunt has a small effect on arterial O2 levels. However, the anatomic shunt can increase with inflammatory airway disease and cause significant reductions in arterial O2 levels.

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