Gadolinium prevents high airway pressure-induced permeability increases in isolated rat lungs

To determine theinitial signaling event in the vascular permeability increase afterhigh airway pressure injury, we compared groups of lungs ventilated atdifferent peak inflation pressures (PIPs) with (gadolinium group) andwithout (control group) infusion of 20 µM gadolinium chloride, aninhibitor of endothelial stretch-activated cationchannels. Microvascular permeability was assessed by using the capillary filtration coefficient(K_fc), ameasure of capillary hydraulic conductivity.K_fc was measuredafter ventilation for 30-min periods with 7, 20, and 30 cmH₂O PIP with 3 cmH₂O positive end-expiratorypressure and with 35 cmH₂O PIPwith 8 cmH₂O positive end-expiratory pressure. In control lungs,K_fc increasedsignificantly to 1.8 and 3.7 times baseline after 30 and 35 cmH₂O PIP, respectively. In thegadolinium group,K_fc was unchangedfrom baseline (0.060 ± 0.010 ml · min¹ · cmH₂O¹ · 100 g¹) after any PIPventilation period. Pulmonary vascular resistance increasedsignificantly from baseline in both groups before the lastK_fc measurementbut was not different between groups. These results suggest thatmicrovascular permeability is actively modulated by a cellular responseto mechanical injury and that stretch-activated cation channels mayinitiate this response through increases in intracellular calciumconcentration.

     

Effects of chest wall counterpressures on lung mechanics under high levels of CPAP in humans

Beaumont, Maurice, Damien Lejeune, Henri Marotte, AlainHarf, and Frédéric Lofaso. Effects of chest wallcounterpressures on lung mechanics under high levels of CPAP in humans.J. Appl. Physiol. 83(2): 591-598, 1997.We assessed the respective effects of thoracic (TCP) andabdominal/lower limb (ACP) counterpressures on end-expiratory volume(EEV) and respiratory muscle activity in humans breathing at 40 cmH₂O of continuous positiveairway pressure (CPAP). Expiratory activity was evaluated on the basis of the inspiratory drop in gastric pressure (Pga) from its maximal end-expiratory level, whereas inspiratory activity was evaluated on thebasis of the transdiaphragmatic pressure-time product (PTPdi). CPAPinduced hyperventilation (+320%) and only a 28% increase in EEVbecause of a high level of expiratory activity (Pga = 24 ± 5 cmH₂O), contrasting with areduction in PTPdi from 17 ± 2 to 9 ± 7 cmH₂O · s¹ · cycle¹during 0 and 40 cmH₂O of CPAP,respectively. When ACP, TCP, or both were added, hyperventilationdecreased and PTPdi increased (19 ± 5, 21 ± 5, and 35 ± 7 cmH₂O · s¹ · cycle¹,respectively), whereas Pga decreased (19 ± 6, 9 ± 4, and 2 ± 2 cmH₂O, respectively). Weconcluded that during high-level CPAP, TCP and ACP limit lunghyperinflation and expiratory muscle activity and restore diaphragmaticactivity.

     

Lung resistance and elastance in spontaneously breathing preterm infants: effects of breathing pattern and demographics

Reported values of lung resistance(RL) and elastance (EL) in spontaneouslybreathing preterm neonates vary widely. We hypothesized that thisvariability in lung properties can be largely explained by both inter-and intrasubject variability in breathing pattern and demographics.Thirty-three neonates receiving nasal continuous positive airwaypressure [weight 606-1,792 g, gestational age (GA) of25-33 wk, 2-49 days old] were studied. Transpulmonary pressure was measured by esophageal manometry and airway flow by facemask pneumotachography. Breath-to-breath changes in RL andEL in each infant were estimated by Fourier analysis ofimpedance (Z) and by multiple linear regression (MLR).RL_MLR (RL_MLR = 0.85 × RL_Z 0.43; r² = 0.95) and EL_MLR(EL_MLR = 0.97 × EL_Z + 8.4; r² = 0.98) werehighly correlated to RL_Z andEL_Z, respectively. Both RL(mean ± SD; RL_Z = 70 ± 38, RL_MLR = 59 ± 36 cmH₂O · s · l¹)and EL (EL_Z = 434 ± 212, EL_MLR = 436 ± 210 cmH₂O/l)exhibited wide intra- and intersubject variability.Regardless of computation method, RL was found to decreaseas a function of weight, age, respiratory rate (RR), and tidal volume(VT) whereas it increased as a function ofRR · VT and inspiratory-to-expiratorytime ratio (TI/TE). EL decreasedwith increasing weight, age, VT and female gender andincreased as RR and TI/TE increased. Weconclude that accounting for the effects of breathing patternvariability and demographic parameters on estimates of RLand EL is essential if they are to be of clinical value.Multivariate statistical models of RL and ELmay facilitate the interpretation of lung mechanics measurements inspontaneously breathing infants.

     

Upper airway muscle activity and upper airway resistance in young adults during sleep

Henke, Kathe G. Upper airway muscle activity and upperairway resistance in young adults during sleep. J. Appl. Physiol. 84(2): 486-491, 1998.To determinethe relationship between upper airway muscle activity and upper airwayresistance in nonsnoring and snoring young adults, 17 subjects werestudied during sleep. Genioglossus and alae nasi electromyogramactivity were recorded. Inspiratory and expiratory supraglotticresistance (Rinsp and Rexp, respectively) were measured at peak flow,and the coefficients of resistance(K_insp andK_exp,respectively) were calculated. Data were recorded during control,with continuous positive airway pressure (CPAP), and on the breathimmediately after termination of CPAP. Rinsp during control averaged 7 ± 1 and 10 ± 2 cmH₂O · l¹ · sand K_inspaveraged 26 ± 5 and 80 ± 27 cmH₂O · l¹ · s²in the nonsnorers and snorers, respectively(P = not significant). Onthe breath immediately after CPAP,K_insp did notincrease over control in snorers (80 ± 27 for control vs. 46 ± 6 cmH₂O · l¹ · s²for the breath after CPAP) or nonsnorers (26 ± 5 vs. 29 ± 6 cmH₂O · l¹ · s²).These findings held true for Rinsp.K_exp did notincrease in either group on the breath immediately after termination ofCPAP. Therefore, 1) increases inupper airway resistance do not occur, despite reductions inelectromyogram activity in young snorers and nonsnorers, and2) increases in Rexp and expiratoryflow limitation are not observed in young snorers.

     

High-frequency oscillatory ventilation in neonatal RDS: initial volume optimization and respiratory mechanics

To determine whetherinitial lung volume optimization influences respiratory mechanics,which could indicate the achievement of optimal volume, we studied 17 premature infants with respiratory distress syndrome (RDS) assisted byhigh-frequency oscillatory ventilation. The continuous distendingpressure (CDP) was increased stepwise from 6-8 cmH₂Oup to optimal CDP (OCDP), i.e., that allowing good oxygenation with thelowest inspired O₂ fraction. Respiratory systemcompliance (Crs) and resistance were concomitantlymeasured. Mean OCDP was 16.5 ± 1.2 cmH₂O. InspiredO₂ fraction could be reduced from an initial level of 0.73 ± 0.17 to 0.33 ± 0.07. However, Crs (0.45 ± 0.14ml · cmH₂O¹ · kg¹at starting CDP point) remained unchanged through lung volume optimization but appeared inversely related to OCDP. Similarly, respiratory system resistance was not affected. We conclude that thereis a marked dissociation between oxygenation improvement and Crsprofile during the initial phase of lung recruitment by earlyhigh-frequency oscillatory ventilation in infants with RDS. Thusoptimal lung volume cannot be defined by serial Crs measurement. At themost, low initial Crs suggests that higher CDP will be needed.

     

Heavy snoring with upper airway resistance syndrome may induce intrinsic positive end-expiratory pressure

We studied eightheavy snorers with upper airway resistance syndrome to investigatepotential effects of sleep on expiratory airway and lungresistance, intrinsic positive end-expiratory pressure,hyperinflation, and elastic inspiratory work of breathing (WOB).Wakefulness and non-rapid-eye-movement sleep with high- and withlow-resistance inspiratory effort (H-RIE and L-RIE, respectively) werecompared. No differences in breathing pattern were seen across thethree conditions. In contrast, we found increases in expiratory airwayand lung resistance during H-RIE compared with L-RIE and wakefulness(56 ± 24, 16 ± 4, and 11 ± 4 cmH₂O · l¹ · s,respectively), with attendant increases in intrinsic positive end-expiratory pressure (5.4 ± 1.8, 1.4 ± 0.5, and 1.3 ± 1.3 cmH₂O, respectively) andelastic WOB (6.1 ± 2.2, 3.7 ± 1.2, and 3.4 ± 0.7 J/min, respectively). The increase in WOB during H-RIE is partly causedby the effects of dynamic pulmonary hyperinflation produced by theincreased expiratory resistance. Contrary to the Starling model, amultiple-element compliance model that takes into account theheterogeneity of the pharynx may explain flow limitation duringexpiration.

     

Respiratory system mechanics in sedated, paralyzed, morbidly obese patients

Pelosi, P., M. Croci, I. Ravagnan, M. Cerisara, P. Vicardi,A. Lissoni, and L. Gattinoni. Respiratory system mechanics insedated, paralyzed, morbidly obese patients J. Appl.Physiol. 82(3): 811-818, 1997.The effects ofinspiratory flow and inflation volume on the mechanical properties ofthe respiratory system in eight sedated and paralyzed postoperativemorbidly obese patients (aged 37.6 ± 11.8 yr who had never smokedand had normal preoperative seated spirometry) were investigated byusing the technique of rapid airway occlusion during constant-flowinflation. With the patients in the supine position, we measured theinterrupter resistance (Rint,rs), which in humans probably reflectsairway resistance, the "additional" resistance (Rrs) due toviscoelastic pressure dissipation and time-constant inequalities, andstatic respiratory elastance (Est,rs). Intra-abdominalpressure (IAP) was measured by using a bladder catheter, and functionalresidual capacity was measured by the helium-dilution technique. Theresults were compared with a previous study on 16 normal anesthetizedparalyzed humans. Compared with normal persons, we found that in obesesubjects: 1) functional residualcapacity was markedly lower (0.645 ± 0.208 liter) and IAP washigher (24 ± 2.2 cmH₂O);2) alveolar-arterial oxygenationgradient was increased (178 ± 59 mmHg);3) the volume-pressure curve of therespiratory system was curvilinear with an "inflection" point;4) Est,rs, Rint,rs, and Rrs werehigher than normal (29.3 ± 5.04 cmH₂O/l, 5.9 ± 2.4 cmH₂O ^· l^{1 ·} s,and 6.4 ± 1.6 cmH₂O ^· l^{1 ·} s,respectively); 5) Rint,rs increasedwith increasing inspiratory flow, Est,rs did not change, and Rrsdecreased progressively; and 6) withincreasing inflation volume, Rint,rs and Est,rs decreased, whereasRrs rose progressively. Overall, our data suggest that obesesubjects during sedation and paralysis are characterized by hypoxemiaand marked alterations of the mechanical properties of the respiratorysystem, largely explained by a reduction in lung volume due to theexcessive unopposed IAP.

     

Blood flow vs. venous pressure effects on filtration coefficient in oleic acid-injured lung

On the basis ofchanges in capillary filtration coefficient(K_fc) in 24 rabbit lungs, we determined whether elevations in pulmonary venouspressure (Ppv) or blood flow (BF) produced differences infiltration surface area in oleic acid-injured (OA) or control (Con)lungs. Lungs were cyclically ventilated and perfused under zone 3 conditions by using blood and 5% albumin with no pharmacological modulation of vascular tone. Pulmonary arterial, venous, and capillary pressures were measured by using arterial, venous, and double occlusion. Before and during eachK_fc-measurementmaneuver, microvascular/total vascular compliance was measured by usingvenous occlusion.K_fc was measuredbefore and 30 min after injury, by using a Ppv elevation of 7 cmH₂O or a BF elevation from 1 to2 l · min¹ · 100 g¹ to obtain a similardouble occlusion pressure. Pulmonary arterial pressure increased morewith BF than with Ppv in both Con and OA lungs [29 ± 2 vs. 19 ± 0.7 (means ± SE) cmH₂O;P < 0.001]. In OA lungscompared with Con lungs, values ofK_fc (200 ± 40 vs. 83 ± 14%, respectively; P < 0.01) and microvascular/total vascular compliance ratio (86 ± 4 vs. 68 ± 5%, respectively; P < 0.01) increased more with BF than with Ppv. In conclusion, for a given OA-induced increase in hydraulic conductivity, BF elevation increased filtration surface area more than did Ppv elevation. The steep pulmonary pressure profile induced by increased BF could result in therecruitment of injured capillaries and could also shift downstream thecompression point of blind (zone 1) and open injured vessels (zone 2).

     

Alae nasi activation decreases nasal resistance during hyperoxic hypercapnia

It has beenproposed that decreases in nasal resistance (Rn) during hypercapnia areentirely due to vasoconstriction in the nasal cavity. We hypothesizedthat alae nasi (AN) muscle activity dilates the nasal vestibule andcontributes to the decrease in Rn during hypercapnia. Nine normalsubjects were studied during hyperoxic hypercapnia (HH). Rn andvestibular resistance (Rvest) for one nasal passage were measuredsimultaneously with the AN electromyogram before and after nasaldecongestion. HH decreased Rvest from 1.6 ± 0.6 to 0.8 ± 0.9 cmH₂O · l¹ · s(predecongestant) and from 1.3 ± 0.8 to 0.6 ± 0.7 cmH₂O · l¹ · s(postdecongestant; both P < 0.01).Nasal decongestant decreased Rn but not Rvest. Significant inverselinear relationships between Rvest and AN electromyogram weredemonstrated for all subjects. We conclude that in normal subjectsduring HH 1) decreases in Rvest arepredominantly due to increases in AN activity; and2) decreases in Rn are due to acombination of mucosal vasoconstriction and ANactivation.

     

Interaction between airway edema and lung inflation on responsiveness of individual airways in vivo

Brown, Robert H., Wayne Mitzner, and Elizabeth M. Wagner.Interaction between airway edema and lung inflation onresponsiveness of individual airways in vivo. J. Appl.Physiol. 83(2): 366-370, 1997.Inflammatorychanges and airway wall thickening are suggested to cause increasedairway responsiveness in patients with asthma. In fivesheep, the dose-response relationships of individual airways weremeasured at different lung volumes to methacholine (MCh) before andafter wall thickening caused by the inflammatory mediator bradykininvia the bronchial artery. At 4 cmH₂O transpulmonary pressure(Ptp), 5 µg/ml MCh constricted the airways to a maximum of 18 ± 3%. At 30 cmH₂O Ptp, MCh resultedin less constriction (to 31 ± 5%). Bradykinin increased airwaywall area at 4 and 30 cmH₂O Ptp(159 ± 6 and 152 ± 4%, respectively;P < 0.0001). At 4 cmH₂O Ptp, bradykinin decreasedairway luminal area (13 ± 2%; P < 0.01), and the dose-response curve was significantly lower (P = 0.02). At 30 cmH₂O, postbradykinin, the maximalairway narrowing was not significantly different (26 ± 5%;P = 0.76). Bradykinin produced substantial airway wall thickening and slight potentiation ofthe MCh-induced airway constriction at low lung volume. At high lung volume, bradykinin increased wall thickness but had no effecton the MCh-induced airway constriction. We conclude that inflammatoryfluid leakage in the airways cannot be a primary cause of airwayhyperresponsiveness.

     

Phosphotyrosine phosphatase and tyrosine kinase inhibition modulate airway pressure-induced lung injury

We determinedwhether drugs which modulate the state of protein tyrosinephosphorylation could alter the threshold for high airwaypressure-induced microvascular injury in isolated perfused rat lungs.Lungs were ventilated for successive 30-min periods with peak inflationpressures (PIP) of 7, 20, 30, and 35 cmH₂O followed by measurement ofthe capillary filtration coefficient (K_fc), asensitive index of hydraulic conductance. In untreated control lungs,K_fc increased by1.3- and 3.3-fold relative to baseline (7 cmH₂O PIP) after ventilation with30 and 35 cmH₂O PIP. However, inlungs treated with 100 µM phenylarsine oxide (a phosphotyrosinephosphatase inhibitor),K_fc increased by4.7- and 16.4-fold relative to baseline at these PIP values. In lungs treated with 50 µM genistein (a tyrosine kinase inhibitor),K_fc increasedsignificantly only at 35 cmH₂OPIP, and the three groups were significantly different from each other.Thus phosphotyrosine phosphatase inhibition increased thesusceptibility of rat lungs to high-PIP injury, and tyrosine kinaseinhibition attenuated the injury relative to the high-PIP control lungs.

     

Effects of prior exercise on exercise-induced arterial hypoxemia in young women

Twenty-eighthealthy women (ages 27.2 ± 6.4 yr) with widely varying fitnesslevels [maximal O₂consumption (O_{2 max}),31-70 ml · kg¹ · min¹]first completed a progressive incremental treadmill test to O_{2 max} (totalduration, 13.3 ± 1.4 min; 97 ± 37 s at maximal workload), rested for 20 min, and then completed a constant-load treadmill test at maximal workload (total duration, 143 ± 31 s). Atthe termination of the progressive test, 6 subjects had maintained arterial PO₂(Pa_O2) near resting levels, whereas 22 subjects showed a >10 Torr decrease inPa_O2 [78.0 ± 7.2 Torr, arterial O₂ saturation(Sa_O2), 91.6 ± 2.4%], andalveolar-arterial O₂ difference (A-aD_O2,39.2 ± 7.4 Torr). During the subsequent constant-load test, allsubjects, regardless of their degree of exercise-induced arterialhypoxemia (EIAH) during the progressive test, showed a nearly identicaleffect of a narrowed A-aD_O2(4.8 ± 3.8 Torr) and an increase inPa_O2 (+5.9 ± 4.3 Torr) andSa_O2 (+1.6 ± 1.7%) compared with atthe end point of the progressive test. Therefore, EIAH during maximalexercise was lessened, not enhanced, by prior exercise, consistent withthe hypothesis that EIAH is not caused by a mechanismwhich persists after the initial exercise period and is aggravated bysubsequent exercise, as might be expected of exercise-inducedstructural alterations at the alveolar-capillary interface. Rather,these findings in habitually active young women point to a functionallybased mechanism for EIAH that is present only during the exerciseperiod.

     

Elastic moduli of excised constricted rat lungs

When airways constrict, the surrounding parenchyma undergoesstretch and distortion. Because of the mechanical interdependence between airways and parenchyma, the material properties of the parenchyma are important factors that modulate the degree ofbronchoconstriction. The purpose of this study was to investigate theeffect of changes in transpulmonary pressure (Ptp) and inducedconstriction on parenchymal bulk (k)and shear (µ) moduli. In excised rat lungs, pressure was measured atthe airway opening, and pressure-volume curves were obtained byimposing step decreases in volume with a calibrated syringe from totallung inflation. Calculation was made ofk during small-volume oscillations (1 Hz). Absolute lung volume at 0 cmH₂O Ptp was obtained bysaline displacement. To calculate µ, a lung-indentation test wasperformed. The lung surface was deformed with a cylindrical punch(diameter = 0.45 cm) in 0.25-mm increments, and the force required toeffect this displacement was measured by a weight balance. Measurementsof k and µ were obtained at 4 and 10 cmH₂O Ptp, and again at 4 cmH₂O Ptp, after delivery ofmethacholine aerosol (100 mg/ml) into the trachea. Values ofk and µ in rat lungs were similar tothose reported in other species. In addition, k and µ were dependent on Ptp. Afterinduced constriction, k and µ increased significantly. That k and µ can increase after induced constriction has important implicationsvis a vis the factors modulating airway narrowing.

     

Skeletal muscle chemoreflex and pHi in exercise ventilatory control

Oelberg, David A., Allison B. Evans, Mirko I. Hrovat, PaulP. Pappagianopoulos, Samuel Patz, and David M. Systrom. Skeletal muscle chemoreflex and pH_i inexercise ventilatory control. J. Appl.Physiol. 84(2): 676-682, 1998.To determinewhether skeletal muscle hydrogen ion mediates ventilatory drive inhumans during exercise, 12 healthy subjects performed three bouts ofisotonic submaximal quadriceps exercise on each of 2 days in a 1.5-Tmagnet for ³¹P-magnetic resonancespectroscopy(³¹P-MRS). Bilaterallower extremity positive pressure cuffs were inflated to 45 Torr duringexercise (BLPP_ex) or recovery(BLPP_rec) in a randomized orderto accentuate a muscle chemoreflex. Simultaneous measurements were madeof breath-by-breath expired gases and minute ventilation, arterializedvenous blood, and by ³¹P-MRS ofthe vastus medialis, acquired from the average of 12 radio-frequencypulses at a repetition time of 2.5 s. WithBLPP_ex, end-exercise minuteventilation was higher (53.3 ± 3.8 vs. 37.3 ± 2.2 l/min;P < 0.0001), arterializedPCO₂ lower (33 ± 1 vs. 36 ± 1 Torr; P = 0.0009), and quadricepsintracellular pH (pH_i) more acid (6.44 ± 0.07 vs. 6.62 ± 0.07; P = 0.004), compared withBLPP_rec. Bloodlactate was modestly increased withBLPP_ex but without a change inarterialized pH. For each subject, pH_i was linearly relatedto minute ventilation during exercise but not to arterialized pH. Thesedata suggest that skeletal muscle hydrogen ion contributes to theexercise ventilatory response.

     

Alveolar epithelial fluid clearance persists in the presence of moderate left atrial hypertension in sheep

The effect of moderate left atrial(LA) hypertension on alveolar liquid clearance (ALC) wasinvestigated in anesthetized, ventilated sheep, surgically prepared tomeasure lung lymph flow as well as hemodynamics. To simulate alveolaredema, 3-4 ml/kg of isosmolar 5% albumin in Ringer lactate wereinstilled into each lower lobe, and ALC was measured. After 4 h of LAhypertension (24 cmH₂O), ALC wassimilar to that in control sheep (31 ± 3% with LA hypertension vs.34 ± 10% with normal LA pressure). Because plasma epinephrinelevels were moderately elevated in the presence of LA hypertension, ALCwas then studied in the presence of LA hypertension following bilateraladrenalectomy. Without endogenous release of epinephrine, ALC wassignificantly reduced compared with normal LA pressure (20 ± 7%compared with 34 ± 10%, P < 0.05). Thus endogenous catecholamines caused a submaximal stimulation of ALC in the presence of LA hypertension. Exogenous administration ofaerosolized ₂-agonist therapywith salmeterol increased ALC in the presence of normal LA pressure buthad no stimulatory effect in the presence of moderate LA hypertension.Therefore, we tested the hypothesis that endogenous release of atrialnatriuretic factor (ANF) may downregulate alveolar epithelialNa⁺ and fluid transport in thepresence of LA hypertension. There was a modest twofold increase inplasma ANF levels after LA hypertension. Additional in vitro studiesdemonstrated that, in the presence of₂-agonist stimulation, ANFdecreased Na⁺ pump activity(Na⁺-K⁺-ATPase)in isolated rat alveolar epithelial type II cells. ANF may downregulatevectorial Na⁺ and fluid transportstimulated by endogenous or exogenous -adrenergic agoniststimulation in the presence of LA hypertension. In summary, ALCcontinues even in the presence of moderate LA hypertension. Aerosolized₂-adrenergic agonist therapysignificantly increased ALC, but only when LA pressure was normal.

     

Ultrasound evaluation of piglet diaphragm function before and after fatigue

Kocis, Keith C., Peter J. Radell, Wayne I. Sternberger, JaneE. Benson, Richard J. Traystman, and David G. Nichols. Ultrasound evaluation of piglet diaphragm function before and after fatigue. J. Appl. Physiol. 83(5):1654-1659, 1997.Clinically, a noninvasive measure of diaphragmfunction is needed. The purpose of this study is to determine whetherultrasonography can be used to 1)quantify diaphragm function and 2)identify fatigue in a piglet model. Five piglets were anesthetized withpentobarbital sodium and halothane and studied during the followingconditions: 1) baseline (spontaneous breathing); 2) baseline + CO₂ [inhaledCO₂ to increase arterial PCO₂ to 50-60 Torr (6.6-8kPa)]; 3) fatigue + CO₂ (fatigue induced with 30 minof phrenic nerve pacing); and 4)recovery + CO₂ (recovery after 1 hof mechanical ventilation). Ultrasound measurements of the posteriordiaphragm were made (inspiratory mean velocity) in the transverseplane. Images were obtained from the midline, just inferior to thexiphoid process, and perpendicular to the abdomen. M-mode measures weremade of the right posterior hemidiaphragm in the plane just lateral tothe inferior vena cava. Abdominal and esophageal pressures weremeasured and transdiaphragmatic pressure (Pdi) was calculated duringspontaneous (Sp) and paced (Pace) breaths. Arterial blood gases werealso measured. Pdi(Sp) and Pdi(Pace)during baseline + CO₂ were 8 ± 0.7 and 49 ± 11 cmH₂O, respectively, anddecreased to 6 ± 1.0 and 27 ± 7 cmH₂O,respectively, during fatigue + CO₂. Mean inspiratory velocityalso decreased from 13 ± 2 to 8 ± 1 cm/s during theseconditions. All variables returned to baseline during recovery + CO₂. Ultrasonography can beused to quantify diaphragm function and identify piglet diaphragm fatigue.

     

H2O2 increases sheep tracheal blood flow, permeability, and vascular response to luminal capsaicin

Wells, U. M., S. Duneclift, and J. G. Widdicombe.H₂O₂increases sheep tracheal blood flow, permeability, and vascular response to luminal capsaicin. J. Appl.Physiol. 82(2): 621-631, 1997.Exogenous hydrogenperoxide(H₂O₂)causes airway epithelial damage in vitro. We have studied the effectsof luminalH₂O₂in the sheep trachea in vivo on tracheal permeability tolow-molecular-weight hydrophilic (technetium-99m-labeleddiethylenetriamine pentaacetic acid;^99mTc-DTPA) and lipophilic([¹⁴C]antipyrine;[¹⁴C]AP) tracers andon the tracheal vascular response to luminal capsaicin, whichstimulates afferent nerve endings. A tracheal artery was perfused, andtracheal venous blood was collected. H₂O₂exposure (10 mM) reduced tracheal potential difference(42.0 ± 6.4 mV) to zero. It increased arterial andvenous flows (56.7 ± 6.1 and 57.3 ± 10.0%,respectively; n = 5, P < 0.01, paired t-test) but not tracheal lymph flow(unstimulated flow 5.0 ± 1.2 µl ^· min^{1 ·} cm¹,n = 4). DuringH₂O₂exposure, permeability to ^99mTc-DTPA increased from2.6 to 89.7 × 10⁷ cm/s(n = 5, P < 0.05), whereas permeability to[¹⁴C]AP (3,312.6 × 10⁷ cm/s,n = 4) was not altered significantly(2,565 × 10⁷cm/s). Luminal capsaicin (10 µM) increased tracheal blood flow (10.1 ± 4.1%, n = 5)and decreased venous ^99mTc-DTPAconcentration (19.7 ± 4.0, P < 0.01), and these effects weresignificantly greater after epithelial damage (28.1 ± 6.0 and45.7 ± 4.3%, respectively,P < 0.05, unpairedt-test). Thus H₂O₂increases the penetration of a hydrophilic tracer into tracheal bloodand lymph but has less effect on a lipophilic tracer. It also enhancesthe effects of luminal capsaicin on blood flow and tracer uptake.

     

Effects of changes in pH and CO2 on pulmonary arterial wall tension are not endothelium dependent

We examined thechanges in isolated pulmonary artery (PA) wall tension on switchingfrom control conditions (pH 7.38 ± 0.01, PCO₂ 32.9 ± 0.4 Torr) toisohydric hypercapnia (pH change 0.00 ± 0.01, PCO₂ change 24.9 ± 1.1 Torr) ornormocapnic acidosis (pH change 0.28 ± 0.01, PCO₂ change 0.3 ± 0.04 Torr) and the role of the endothelium in these responses. In rat PA, submaximally contracted with phenylephrine, isohydric hypercapnia did not cause a significant change in mean (± SE) tension [3.0 ± 1.8% maximal phenylephrine-induced tension(P_o)]. Endothelial removal did not alter this response. In aorticpreparations, isohydric hypercapnia caused significant(P < 0.01) relaxation (27.4 ± 3.2% P_o), which waslargely endothelium dependent. Normocapnic acidosis caused relaxationof PA (20.2 ± 2.6% P_o), which was less(P < 0.01) than that observed in aorticpreparations (35.7 ± 3.4%P_o). Endothelial removal leftthe pulmonary response unchanged while increasing(P < 0.01) the aortic relaxation(53.1 ± 4.4% P_o).These data show that isohydric hypercapnia does not alter PA tone.Reduction of PA tone in normocapnic acidosis is endothelium independentand substantially less than that of systemic vessels.

     

Optical measurement of isolated canine lung filtration coefficients after alloxan infusion

In this study, lung filtration coefficient(K_fc) wasmeasured in eight isolated canine lung preparations by using threemethods: standard gravimetric (Std), blood-corrected gravimetric (BC), and optical. The lungs were held in zone III conditions and were subjected to an average venous pressure increase of 8.79 ± 0.93 (mean ± SD) cmH₂O. Thepermeability of the lungs was increased with an infusion of alloxan (75 mg/kg). The resultingK_fc values (inmilliliters · min¹ · cmH₂O¹ · 100 g dry lung weight¹)measured by using Std and BC gravimetric techniques before vs. afteralloxan infusion were statistically different: Std, 0.527 ± 0.290 vs. 1.966 ± 0.283; BC, 0.313 ± 0.290 vs. 1.384 ± 0.290. However, the optical technique did not show any statisticaldifference between pre- and postinjury with alloxan, 0.280 ± 0.305 vs. 0.483 ± 0.297, respectively. The alloxan injury, quantified byusing multiple-indicator techniques, showed an increase in permeability and a corresponding decrease in reflection coefficient for albumin (_f). Because the opticalmethod measures the product ofK_fc and _f, this study shows thatalbumin should not be used as an intravascular optical filtrationmarker when permeability is elevated. However, the optical technique,along with another means of measuringK_fc (such as BC),can be used to calculate the _fof a tracer (in this study, _fof 0.894 at baseline and 0.348 after injury). Another important findingof this study was that the ratio of baseline-to-injury K_fc values wasnot statistically different for Std and BC techniques, indicating thatthe percent contribution of slow blood-volume increases does not changebecause of injury.

     

Optical measurement of isolated canine lung filtration coefficients at normal hematocrits

Klaesner, Joseph W., N. Adrienne Pou, Richard E. Parker,Charlene Finney, and Robert J. Roselli. Optical measurement ofisolated canine lung filtration coefficients at normal hematocrits. J. Appl. Physiol. 83(6):1976-1985, 1997.In this study, lung filtration coefficient(K_fc) valueswere measured in eight isolated canine lung preparations at normalhematocrit values using three methods: gravimetric, blood-correctedgravimetric, and optical. The lungs were kept in zone 3 conditions andsubjected to an average venous pressure increase of 10.24 ± 0.27 (SE) cmH₂O. The resulting K_fc(ml · min¹ · cmH₂O¹ · 100 g dry lung wt¹) measuredwith the gravimetric technique was 0.420 ± 0.017, which wasstatistically different from theK_fc measured bythe blood-corrected gravimetric method (0.273 ± 0.018) or theproduct of the reflection coefficient(_f) andK_fc measuredoptically (0.272 ± 0.018). The optical method involved the use of aCellco filter cartridge to separate red blood cells from plasma, whichallowed measurement of the concentration of the tracer in plasma atnormal hematocrits (34 ± 1.5). The permeability-surface areaproduct was measured using radioactive multiple indicator-dilutionmethods before, during, and after venous pressure elevations. Resultsshowed that the surface area of the lung did not change significantlyduring the measurement ofK_fc. Thesestudies suggest that_fK_fccan be measured optically at normal hematocrits, that this measurement is not influenced by blood volume changes that occur during the measurement, and that the optical_fK_fcagrees with theK_fc obtained viathe blood-corrected gravimetric method.