Ventilation inhomogeneity in oleic acid-induced pulmonary edema

Tsang, John Y. C., Michael J. Emery, and Michael P. Hlastala. Ventilation inhomogeneity in oleic acid-inducedpulmonary edema. J. Appl. Physiol.82(4): 1040-1045, 1997.Oleic acid causes permeability pulmonaryedema in the lung, resulting in impairment of gas-exchange andventilation-perfusion heterogeneity and mismatch. Previous studies haveshown that by using the multiple-breath helium washout (MBHW)technique, ventilation inhomogeneity (VI) can be quantitativelypartitioned into two components, i.e., convective-dependent inhomogeneity (cdi) and diffusive-convective-dependent inhomogeneity (dcdi). Changes in VI, as represented by the normalized slope of thephase III alveolar plateau, were studied for 120 min in fiveanesthetized mongrel dogs that were ventilated under paralysis by aconstant-flow linear motor ventilator. These animals received oleicacid (0.1 mg/kg) infusion into the right atrium att = 0. MBHWs were done induplicate for 18 breaths every 40 min afterward. Three other dogs thatreceived only normal saline served as controls. The data show that,after oleic acid infusion, dcdi, which represents VI in peripheralairways, is responsible for the increasing total VI as lung wateraccumulates progressively over time. The cdi, which represents VIbetween larger conductive airways, remains relatively constantthroughout. This observation can be explained by increases in theheterogeneity of tissue compliance in the periphery, distal airwayclosure, or by decreases in ventilation through collateral channels.

     

Changes in regional lung mechanics and ventilation distribution after unilateral pulmonary artery occlusion

Simon, Brett A., Koichi Tsuzaki, and Jose G. Venegas.Changes in regional lung mechanics and ventilation distribution after unilateral pulmonary artery occlusion. J. Appl.Physiol. 82(3): 882-891, 1997.Regionalpneumoconstriction induced by alveolar hypocapnia is an importanthomeostatic mechanism for optimization of ventilation-perfusionmatching. We used positron imaging of ¹³NN-equilibrated lungs to measurethe distribution of regional tidal volume(VT), lung volume(VL), and lung impedance(Z) before and after left (L)pulmonary artery occlusion (PAO) in eight anesthetized, open-chestdogs. Measurements were made during eucapnic sinusoidal ventilation at0.2 Hz with 4-cmH₂O positive end expiratory pressure. Right(R) and L lung impedances(ZRandZL)were determined from carinal pressure and positron imaging of dynamicregional VL. LPAO caused anincrease in|ZL|relative to|ZR|,resulting in a shift in VT awayfrom the PAO side, with a L/R|Z| ratio changing from 1.20 ± 0.07 (mean ± SE) to 2.79 ± 0.85 after LPAO(P < 0.05). Although mean L lungVL decreased slightly, theVL normalized parametersspecific admittance and specific compliance both significantly decreased with PAO. Lung recoil pressure at 50% totallung capacity also increased after PAO. We conclude that PAO results inan increase in regional lung Z thatshifts ventilation away from the affected area at normal breathingfrequencies and that this effect is not due to a change inVL but reflects mechanicalconstriction at the tissue level.

     

Perfluorochemical rescue after surfactant treatment: effect of perflubron dose and ventilatory frequency

Wolfson, Marla R., Nancy E. Kechner, Robert F. Roache,Jean-Pierre DeChadarevian, Helena E. Friss, S. David Rubenstein, andThomas H. Shaffer. Perfluorochemical rescue after surfactant treatment: effect of perflubron dose and ventilatory frequency. J. Appl. Physiol. 84(2): 624-640, 1998.To test the hypotheses that perfluorochemical (PFC) liquidrescue after natural surfactant (SF) treatment would improve pulmonaryfunction and histology and that this profile would be influenced by PFCdose or ventilator strategy, anesthetized preterm lambs(n = 31) with respiratory distresswere studied using nonpreoxygenated perflubron. All animals received SFat 1 h and were randomized at 2 h as follows and studied to 4 h postnatal age: 1) conventionalmechanical gas ventilation (n = 8),2) 30 ml/kg perflubron with gasventilation [partial liquid ventilation (PLV)] at 60 breaths/min (n = 8),3) 10 ml/kg perflubron with PLV at60 breaths/min (n = 7), and4) 10 ml/kg perflubron with PLV at30 breaths/min (n = 8). All animalstolerated instillation without additional cardiopulmonary instability.All perflubron-rescued groups demonstrated sustained improvement in gasexchange, respiratory compliance, and reduction in pressure requirements relative to animals receiving SF alone. Improvement wasdirectly related to perflubron dose and breathing frequency; peakinspiratory pressure required to achieve physiological gas exchange waslower in the higher-dose and -frequency groups, and mean airwaypressure was lower in the lower-frequency group. Lung expansion wasgreater and evidence of barotrauma was less in the higher-dose and-frequency group; regional differences in expansion were not differentas a function of dose but were greater in the lower-frequency group.Regional differences in lung perflubron content were reduced in thehigher-dose and -frequency groups and greatest in the lower-dose and-frequency group. The results suggest that, whereas PLV of theSF-treated lung improves gas exchange and lung mechanics, theprotective benefits of perflubron in the lung may depend on dose andventilator strategy to optimize PFC distribution and minimize exposureof the alveolar-capillary membrane to a gas-liquid interface.

     

Tidal volume effects on surfactant treatment responses with the initiation of ventilation in preterm lambs

Wada, Kazuko, Alan H. Jobe, and Machiko Ikegami. Tidalvolume effects on surfactant treatment responses with the initiation ofventilation in preterm lambs. J. Appl.Physiol. 83(4): 1054-1061, 1997.We hypothesizedthat initiation of ventilation in preterm lambs with high volumes wouldcause lung injury and decrease the subsequent response to surfactanttreatment. Preterm lambs were randomized to ventilation for 30 minafter birth with 5 ml/kg (VT5),10 ml/kg (VT10), or 20 ml/kg(VT20) tidal volumes and then ventilated with ~10 ml/kg tidal volumes to achieve arterialPCO₂ values of ~50 Torr to 6 h ofage. VT20 lambs had lowercompliances, lower ventilatory efficiencies, higher recoveries ofprotein, and lower recoveries of surfactant in alveolar lavages and in surfactant that had decreased compliances when tested in preterm rabbits than VT5 orVT10 lambs. Other lambsrandomized to treatment with surfactant at birth and ventilation with6, 12, or 20 ml/kg tidal volumes for 30 min had no indicators of lunginjury. An initial tidal volume of 20 ml/kg decreased the subsequentresponse to surfactant treatment, an effect that was prevented withsurfactant treatment at birth.

     

Effect of tidal volume and frequency on airway responsiveness in mechanically ventilated rabbits

Shen, X., S. J. Gunst, and R. S. Tepper. Effect oftidal volume and frequency on airway responsiveness in mechanically ventilated rabbits. J. Appl. Physiol.83(4): 1202-1208, 1997.We evaluated the effects of the rate andvolume of tidal ventilation on airway resistance (Raw) duringintravenous methacholine (MCh) challenge in mechanically ventilatedrabbits. Five rabbits were challenged at tidal volumes of 5, 10, and 20 ml/kg at a frequency of 15 breaths/min and also under static conditions(0 ml/kg tidal volume). Four rabbits were subjected to MCh challenge atfrequencies of 6 and 30 breaths/min with a tidal volume of 10 ml/kg andalso under static conditions. In both groups, the increase in Raw with MCh challenge was significantly greater under static conditions thanduring tidal ventilation at any frequency or volume. Increases in thevolume or frequency of tidal ventilation resulted in significant decreases in Raw in response to MCh. We conclude that tidal breathing suppresses airway responsiveness in rabbits in vivo. The suppression ofnarrowing in response to MCh increases as the magnitude of the volumeor the frequency of the tidal oscillations is increased. Our findingssuggest that the effect of lung volume changes on airway responsivenessin vivo is primarily related to the stretch of airway smooth muscle.

     

A servo-controlled respiration system for inhalation studies in anesthetized animals

Rosenthal, Frank S., and Changhong Li. Aservo-controlled respiration system for inhalation studies inanesthetized animals. J. Appl.Physiol. 83(5): 1768-1774, 1997.To facilitate aerosol deposition experiments and aerosol exposures in anesthetized animals, a servo-controlled respiration system was developed and tested. The system induces ventilation by varying extrathoracic pressure in a whole body respirator in which an intubated animal isplaced. The pressure inside the whole body respirator is varied with athree-way servo-controlled spool valve connected to sources of positiveand negative pressure. A computer-based system detects respiratory flowand computes the controlling signal for the valve by using aproportional-integral-derivative algorithm, to achieve desired patternsof flow and volume vs. time. The system was used with dogs and found toaccurately induce various single-breath breathing patterns involvingconstant-flow inspirations and expirations as well as breath-holdperiods. A similar system was used to induced repeated breaths withdesired parameters for continuous exposure to particles and forventilation of animals between experiments.

     

Ragweed sensitization alters pulmonary vascular responses to bronchoprovocation in beagle dogs

Theodorou, Andreas, Natalie Weger, Kathleen Kunke, KyooRhee, David Bice, Bruce Muggenberg, and Richard Lemen. Ragweed sensitization alters pulmonary vascular responses to bronchoprovocation in beagle dogs. J. Appl. Physiol.83(3): 912-917, 1997.In ragweed (RW)-sensitized beagle dogs, wetested the hypothesis that reactivity of the pulmonary vasculature wasenhanced with aerosolized histamine (Hist) and RW. Seven dogs wereneonatally sensitized with repeated intraperitoneal RW injections, and12 dogs were controls (Con). The dogs were anesthetizedwith intravenous chloralose, mechanically ventilated, and instrumentedwith femoral arterial and pulmonary artery catheters. Specific lungcompliance(CL_sp),specific lung conductance (G_sp),systemic vascular resistance index, and pulmonary vascular resistanceindex (PVRI) were measured before and after bronchoprovocation withHist and RW. After Hist inhalation (5 breaths of 30 mg/ml), both Conand RW dogs had significant (P < 0.05) decreases inCL_sp(51 ± 4 and 53 ± 5%, respectively) andG_sp (65 ± 5 and69 ± 3%, respectively), but only RW-sensitized dogs had asignificant increase in PVRI (38 ± 10%). After RW inhalation (60 breaths of 0.8 mg/ml), only RW-sensitized dogs had significant increases (62 ± 20%) in PVRI and decreases inG_sp (77 ± 4%) and CL_sp(65 ± 7%). We conclude that, compared with Con,RW-sensitized beagle dogs have increased pulmonary vasoconstrictiveresponses with Hist or RW inhalation.

     

Zone of apposition in the passive diaphragm of the dog

Boriek, Aladin M., Joseph R. Rodarte, and Susan S. Margulies. Zone of apposition in the passive diaphragm of thedog. J. Appl. Physiol. 81(5): 1929-1940, 1996.Wedetermined the regional area of the diaphragmatic zone of apposition(ZAP) as well as the regional craniocaudal extent of the ZAP(ZAP_ht) of the passive diaphragm in six paralyzedanesthetized beagle dogs (8-12 kg) at residual lung volume (RV),functional residual capacity (FRC), FRC + 0.25 and FRC + 0.5 inspiratory capacity, and total lung capacity (TLC) in prone and supinepostures. To identify the caudal boundary of the ZAP, 17 lead markers(1 mm) were sutured to the abdominal side of the costal and cruraldiaphragms around the diaphragm insertion on the chest wall. Two weekslater, the dogs' caudal thoraces were scanned by the use of thedynamic spatial reconstructor (DSR), a prototype fast volumetric X-raycomputer tomographic scanner, developed at the Mayo Clinic. Thethree-dimensional spatial coordinates of the markers were identified(±1.4 mm), and the cranial boundary of the ZAP was determined from30-40 1.4-mm-thick sagittal and coronal slices in each DSR image.We interpolated the DSR data to find the position of the cranial andcaudal boundaries of the ZAP every 5° around the thorax and computedthe distribution of regional variation of area of the ZAP andZAP_ht as well as the total area of ZAP. TheZAP_ht and area of ZAP increased as lung volume decreasedand were largest near the lateral extremes of the rib cage. We measuredthe surface area of the rib cage cephaled to the ZAP(A_L) in both postures in another six beagle dogs(12-16 kg) of similar stature, scanned previously in the DSR. Weestimated the entire rib cage surface area(A_rc = A_ZAP +A_L). The A_ZAP as a percentageof A_rc increased more than threefold as lung volumedecreased from TLC to RV, from ~9 to 29% of A_rc.

     

Control of breathing during sleep assessed by proportional assist ventilation

Meza, S., E. Giannouli, and M. Younes. Control ofbreathing during sleep assessed by proportional assist ventilation. J. Appl. Physiol. 84(1): 3-12, 1998.We used proportional assist ventilation (PAV) to evaluate thesources of respiratory drive during sleep. PAV increases the slope ofthe relation between tidal volume(VT) andrespiratory muscle pressure output (Pmus). We reasoned that ifrespiratory drive is dominated by chemical factors, progressiveincrease of PAV gain should result in only a small increase inVT because Pmus would bedownregulated substantially as a result of small decreases inPCO₂. In the presence of substantialnonchemical sources of drive [believed to be the case inrapid-eye-movement (REM) sleep] PAV should result in a substantial increase in minute ventilation and reductionin PCO₂ as the output related to thechemically insensitive drive source is amplified severalfold. Twelvenormal subjects underwent polysomnography while connected to a PAVventilator. Continuous positive air pressure (5.2 ± 2.0 cmH₂O) was administered tostabilize the upper airway. PAV was increased in 2-min steps from 0 to20, 40, 60, 80, and 90% of the subject's elastance and resistance.VT, respiratory rate, minuteventilation, and end-tidal CO₂pressure were measured at the different levels, and Pmus wascalculated. Observations were obtained in stage 2 sleep (n = 12), slow-wave sleep(n = 11), and REM sleep(n = 7). In all cases, Pmus wassubstantially downregulated with increase in assist so that theincrease in VT, althoughsignificant (P < 0.05), was small(0.08 liter at the highest assist). There was no difference in responsebetween REM and non-REM sleep. We conclude that respiratory driveduring sleep is dominated by chemical control and that there is nofundamental difference between REM and non-REM sleep in this regard.REM sleep appears to simply add bidirectional noise to what isbasically a chemically controlled respiratory output.

     

Delay time adjustments to minimize errors in breath-by-breath measurement of VO2 during exercise

Proctor, David N., and Kenneth C. Beck. Delay timeadjustments to minimize errors in breath-by-breath measurement of O₂ during exercise.J. Appl. Physiol. 81(6):2495-2499, 1996.If the delay time between gas concentration andflow signals is not adequately corrected during breath-by-breathanalysis of expired gas, an error in calculation of oxygen consumption(O₂) will result. Toexamine the frequency and delay time dependences of errors inO₂ measurement, six healthymen exercised at 100, 200, and 250 W on a cycle ergometer whilebreath-by-breath assessment ofO₂ was made simultaneouslywith collection of expired air. Subjects breathed first at normal rates(15-30 breaths/min) and then at 70 breaths/min. Each subjectperformed each level of exercise twice by using erroneous values forthe delay time between gas concentration and flow signals. At normalbreathing frequencies, errors inO₂ measurement were±10% over the full range of delay times used, and the errors werenot tightly correlated with variations in delay times from optimum.However, at 70 breaths/min, errors approached ±30% as thevariations in delay times deviated ±0.1 s from the optimal, and theerrors were highly correlated with the variations in delay times. Weconclude that there is greater potential for errors inO₂ measurement withincorrect delay time at higher breathing frequencies. These findingssuggest that the optimal delay time for breath-by-breath systems shouldbe adjusted by using high breathing frequencies.

     

Ventilation distribution during histamine provocation

Verbanck, S., D. Schuermans, A. Van Muylem, M. Paiva, M. Noppen, and W. Vincken. Ventilation distribution during histamine provocation. J. Appl. Physiol. 83(6):1907-1916, 1997.We investigated ventilation inhomogeneity duringprovocation with inhaled histamine in 20 asymptomatic nonsmokingsubjects. We used N₂multiple-breath washout (MBW) to deriveparameters S_condand S_acin as ameasurement of ventilation inhomogeneity in conductive and acinar zonesof the lungs, respectively. A 20% decrease of forced expiratory volume in 1 s (FEV₁) was used todistinguish responders from nonresponders. In the responder group,average FEV₁ decreased by 26%,whereas S_condincreased by 390% with no significant change inS_acin. In thenonresponder group, FEV₁ decreasedby 11%, whereasS_cond increased by 198% with no significantS_acin change.Despite the absence of change inS_acin duringprovocation, baselineS_acin wassignificantly larger in the responder vs. the nonresponder group. Themain findings of our study are that during provocation largeventilation inhomogeneities occur, that the small airways affected bythe provocation process are situated proximal to the acinar zone wherethe diffusion front stands, and that, in addition to overall decreasein airway caliber, there is inhomogeneous narrowing of parallelairways.

     

Gut and liver fat metabolism in depancreatized dogs: effects of exercise and acute insulin infusion

Namdaran, Kiarash, Deanna P. Bracy, D. Brooks Lacy, JaniceL. Johnson, Jennifer L. Bupp, and David H. Wasserman. Gut andliver fat metabolism in depancreatized dogs: effects of exercise andacute insulin infusion. J. Appl.Physiol. 83(4): 1339-1347, 1997.Excessivecirculating fat levels are a defining feature of poor metabolic controlin diabetes. Splanchnic adipose tissue is a source of free fatty acids(FFA), and the liver is a key site of FFA utilization and the solesource of ketones. Despite the role of splanchnic tissues in fatmetabolism, little is known about how these tissues respond to diabetesunder divergent metabolic conditions. Therefore, splanchnic fatmetabolism was studied in poorly controlled diabetes under twoconditions. First, it was studied during exercise, a stimulus thatenhances FFA flux. Second, it was studied while insulin was beingacutely infused to achieve levels normally present during exercise, atreatment that may be expected to inhibit lipolysis. For this purpose,liver and gut arteriovenous differences were used during rest and 2.5 h of treadmill exercise in insulin-deficient(n = 6) and acutely insulin-infused(n = 4) depancreatized (PX) dogs. Thedata show that 1) exercise, ininsulin-deficient PX dogs, leads to an increase in net FFA release frommesenteric fat that is equal in magnitude to the response innondiabetic dogs; 2) net hepaticfractional FFA extraction is increased twofold during exercise in bothinsulin-deficient PX dogs and nondiabetic control dogs;3) during exercise, ~40 and 75%of the FFA consumed by the liver is effectively transferred from fatstores mobilized from splanchnic adipose tissue in insulin-deficient PXand nondiabetic dogs, respectively;4) hepatic ketogenic efficiency iselevated during rest three- to fourfold in insulin-deficient PX dogscompared with nondiabetic control dogs and remains elevated duringexercise; and 5) surprisingly, acuteinsulin replacement is ineffective in normalizing net gut, hepatic, orsplanchnic FFA or ketone body balances in PX dogs.

     

Mechanisms of stimulation of vagal pulmonary C fibers by pulmonary air embolism in dogs

Chen, H. F., B. P. Lee, and Y. R. Kou. Mechanisms ofstimulation of vagal pulmonary C fibers by pulmonary air embolism indogs. J. Appl. Physiol. 82(3):765-771, 1997.We investigated the involvement of thecyclooxygenase metabolites and hydroxyl radical (^· OH) in thestimulation of vagal pulmonary C fibers (PCs) by pulmonary air embolism(PAE). Impulses were recorded from PCs in 51 anesthetized, open-chest,and artificially ventilated dogs. Fifty of 59 PCs were stimulated byinfusion of air into the right atrium (0.2 ml ^· kg^{1 ·} min¹for 10 min). As a group (n = 59), PCactivity increased from a baseline of 0.4 ± 0.1 to a peak of 1.7 ± 0.2 impulses/s during the period from 1 min before to 2 min afterthe termination of PAE induction. In PCs initially stimulated by PAEinduction, PAE was repeated after the intervening treatment (iv) withsaline (n = 9), ibuprofen (acyclooxygenase inhibitor; n = 11), ordimethylthiourea (a ^· OH scavenger;n = 12). The responses of PCs to PAEwere not altered by saline vehicle but were abolished by ibuprofen and significantly attenuated by dimethylthiourea. Although hyperinflation of the lungs reversed the PAE-induced bronchomotor responses, it didnot reverse the stimulation of PCs (n = 8). These results suggest that 1)cyclooxygenase products are necessary for the stimulation of PCs byPAE, whereas changes in lung mechanics are not, and2) the functional importance ofcyclooxygenase products may be mediated in part through the formationof ^· OH.

     

Restoration of fluid balance after exercise-induced dehydration: effects of alcohol consumption

Shirreffs, Susan M., and Ronald J Maughan. Restorationof fluid balance after exercise-induced dehydration: effects of alcoholconsumption. J. Appl. Physiol. 83(4):1152-1158, 1997.The effect of alcohol consumption on therestoration of fluid and electrolyte balance after exercise-induceddehydration [2.01 ± 0.10% (SD) of body mass] wasinvestigated. Drinks containing 0, 1, 2, and 4% alcohol were consumedover 60 min beginning 30 min after the end of exercise; a differentbeverage was consumed in each of four trials. The volume consumed(2,212 ± 153 ml) was equivalent to 150% of body mass loss. Peakurine flow rate occurred later (P = 0.024) with the 4% beverage. The total volume of urine produced overthe 6 h after rehydration, although not different between trials(P = 0.307), tended to increase as thequantity of alcohol ingested increased. The increase in blood(P = 0.013) and plasma(P = 0.050) volume with rehydrationwas slower when the 4% beverage was consumed and did not increase tovalues significantly greater than the dehydrated level(P = 0.013 andP = 0.050 for blood volume and plasmavolume, respectively); generally, the increase was an inverse functionof the quantity of alcohol consumed. These results suggest that alcoholhas a negligible diuretic effect when consumed in dilute solution aftera moderate level of hypohydration induced by exercise in the heat.There appears to be no difference in recovery from dehydration whetherthe rehydration beverage is alcohol free or contains up to 2% alcohol,but drinks containing 4% alcohol tend to delay the recovery process.

     

Hemodynamic and norepinephrine responses to pacing-induced heart failure in conscious sinoaortic-denervated dogs

Brändle, Marian, Kaushik P. Patel, Wei Wang, andIrving H. Zucker. Hemodynamic and norepinephrine responses topacing-induced heart failure in conscious sinoaortic-denervated dogs.J. Appl. Physiol. 81(4):1855-1862, 1996.The present study was undertaken to determinethe effects of chronic sinoaortic (baroreceptor) denervation (SAD) on the hemodynamic and sympathetic alterations thatoccur in the pacing-induced model of congestive heart failure. Twogroups of dogs were examined: intact(n = 9) and SAD(n = 9). Both groups of dogs werestudied in the control (prepace) state and each week after theinitiation of ventricular pacing at 250 beats/min. After the pacemakerwas turned off, hemodynamic and plasma norepinephrine levels returnedtoward control levels in the prepaced state and after 1 and 2 wk ofpacing. However, by 3 wk all hemodynamic and norepinephrine levelsremained relatively constant over the 10-min observation period withthe pacemaker off. With the pacemaker off, left ventricularend-diastolic pressure went from 2.7 ± 1.4 (SE) mmHg during theprepace state to 23.2 ± 2.9 mmHg in the heart failure state inintact dogs (P < 0.01). Leftventricular end-diastolic pressure increased to 27.1 ± 2.2 mmHgfrom a control level of 4.2 ± 1.9 mmHg in SAD dogs(P < 0.0003). Mean arterial pressuresignificantly decreased in intact and SAD dogs. Resting heart rate wassignificantly higher in SAD dogs and increased to 135.8 ± 8.9 beats/min in intact dogs and 136.1 ± 6.5 beats/min in SAD dogs.There were no significant differences in the hemodynamic parametersbetween intact and SAD dogs after pacing. Plasma norepinephrine wassignificantly lower in intact than in SAD dogs before pacing (197.7 ± 21.6 vs. 320.6 ± 26.6 pg/ml;P < 0.005). In the heart failurestate, plasma norepinephrine increased significantly in both intact(598.3 ± 44.2 pg/ml) and SAD (644.0 ± 64.6 pg/ml) groups. Therewere no differences in the severity or the magnitude of the developedheart failure state in SAD vs. intact dogs. We conclude from these datathat the arterial baroreflex is not the sole mechanism for the increasein sympathetic drive in heart failure.

     

Respiratory impedances and acinar gas transfer in a canine model for emphysema

Barnas, George M., Paul A. Delaney, Ileana Gheorghiu,Srinivas Mandava, Robert G. Russell, Renée Kahn, and Colin F. Mackenzie. Respiratory impedances and acinar gas transfer in acanine model for emphysema. J. Appl.Physiol. 83(1): 179-188, 1997.We examined howthe changes in the acini caused by emphysema affected gas transfer outof the acinus (T_aci) and lungand chest wall mechanical properties. Measurements were taken from fivedogs before and 3 mo after induction of severe bilateral emphysema byexposure to papain aerosol (170-350 mg/dose) for 4 consecutive wk.With the dogs anesthetized, paralyzed, and mechanically ventilated at0.2 Hz and 20 ml/kg, we measuredT_aci by the rate of washout of¹³³Xe from an area of the lungwith occluded blood flow. Measurements were repeated at positiveend-expiratory pressures (PEEP) of 10, 5, 15, 0, and 20 cmH₂O. We also measured dynamicelastances and resistances of the lungs(EL andRL, respectively) and chest wall at the different PEEP and during sinusoidal forcing in the normal rangeof breathing frequency and tidal volume. After final measurements, tissue sections from five randomly selected areas of the lung eachshowed indications of emphysema.T_aci during emphysema was similarto that in control dogs. ELdecreased by ~50% during emphysema (P < 0.05) but did not change itsdependence on frequency or tidal volume.RL did not change(P > 0.05) at the lowest frequencystudied (0.2 Hz), but in some dogs it increased compared with control at the higher frequencies. Chest wall properties were not changed byemphysema (P > 0.05). We suggestthat although large changes in acinar structure andEL occur during uncomplicatedbilateral emphysema, secondary complications must be present to causeseveral of the characteristic dysfunctions seen in patients withemphysema.

     

Superior laryngeal nerve section alters responses to upper airway distortion in sleeping dogs

Curran, Aidan K., Peter R. Eastwood, Craig A. Harms, CurtisA. Smith, and Jerome A. Dempsey. Superior laryngeal nerve sectionalters responses to upper airway distortion in sleeping dogs.J. Appl. Physiol. 83(3): 768-775, 1997.We investigated the effect of superior laryngeal nerve (SLN)section on expiratory time(TE) and genioglossuselectromyogram (EMGgg) responses to upper airway (UA) negative pressure(UANP) in sleeping dogs. The same dogs used in a similar intact study(C. A. Harms, C. A., Y.-J. Zeng, C. A. Smith, E. H. Vidruk, and J. A. Dempsey. J. Appl. Physiol. 80:1528-1539, 1996) were bilaterally SLN sectioned. After recovery,the UA was isolated while the animal breathed through a tracheostomy.Square waves of negative pressure were applied to the UA from below thelarynx or from the mask (nares) at end expiration and held until thenext inspiratory effort. Section of the SLN increased eupneicrespiratory frequency and minute ventilation. Relative to the same dogsbefore SLN section, sublaryngeal UANP caused lessTE prolongation while activation of the genioglossus required less negative pressures. Mask UANP had noeffect on TE or EMGgg activity.We conclude that the SLN 1) is notobligatory for the reflex prolongation ofTE and activation of EMGggactivity produced by UANP and 2)plays an important role in the maintenance of UA stability and thepattern of breathing in sleeping dogs.

     

Effects of surfactant distribution and ventilation strategies on efficacy of exogenous surfactant

The effectsof both surfactant distribution patterns and ventilation strategiesutilized after surfactant administration were assessed in lung-injuredadult rabbits. Animals received 50 mg/kg surfactant via intratrachealinstillation in volumes of either 4 or 2 ml/kg. A subset ofanimals from each treatment group was euthanized for evaluation of theexogenous surfactant distribution. The remaining animals wererandomized into one of three ventilatory groups: group1 [tidal volume(VT) of 10 ml/kg with 5 cmH₂O positive end-expiratorypressure (PEEP)]; group 2 (VT of 5 ml/kg with 5 cmH₂O PEEP); orgroup 3 (VT of 5 ml/kg with 9 cmH₂O PEEP). Animals wereventilated and monitored for 3 h. Distribution of the surfactant wasmore uniform when it was delivered in the 4 ml/kg volume. When thedistribution of surfactant was less uniform, arterial PO₂ values were greater ingroups 2 and3 compared with group1. Oxygenation differences among the differentventilation strategies were less marked in animals with the moreuniform distribution pattern of surfactant (4 ml/kg). In bothsurfactant treatment groups, a high mortality was observed with theventilation strategy used for group 3.We conclude that the distribution of exogenous surfactant affects theresponse to different ventilatory strategies in this model of acutelung injury.

     

Letters to the Editor

The following is the abstract of the article discussed in thesubsequent letter:

Verbanck, S., D. Schuermans, A. Van Muylem, M. Paiva, M. Noppen, and W. Vincken. Ventilation distribution duringhistamine provocation. J. Appl. Physiol.83(6):1907-1916, 1997.We investigated ventilation inhomogeneityduring provocation with inhaled histamine in 20 asymptomatic nonsmokingsubjects. We used N₂ multiple-breath washout (MBW) toderive parameters S_cond andS_acin as a measurement of ventilationinhomogeneity in conductive and acinar zones of the lungs,respectively. A 20% decrease of forced expiratory volume in 1 s(FEV₁) was used to distinguish responders fromnonresponders. In the responder group, average FEV₁decreased by 26%, whereas S_cond increased by390% with no significant change in S_acin. In the nonresponder group, FEV₁ decreased by 11%, whereasS_cond increased by 198% with no significantS_acin change. Despite the absence of change inS_acin during provocation, baselineS_acin was significantly larger in the respondervs. the nonresponder group. The main findings of our study are thatduring provocation large ventilation inhomogeneities occur, that thesmall airways affected by the provocation process are situated proximalto the acinar zone where the diffusion front stands, and that, inaddition to overall decrease in airway caliber, there is inhomogeneousnarrowing of parallel airways.

     

Spatial pattern of pulmonary blood flow distribution is stable over days

Glenny, Robb W., Steven McKinney, and H. Thomas Robertson.Spatial pattern of pulmonary blood flow distribution is stableover days. J. Appl. Physiol. 82(3):902-907, 1997.Despite the heterogeneous distribution of regionalpulmonary perfusion over space, local perfusion remains stable overshort time periods (20-100 min). The purpose ofthis study was to determine whether the spatial distribution ofpulmonary perfusion remains stable over longer time periods (1-5days). Regional blood flow was measured each day for 5 days in five awake standing dogs. Fluorescent microspheres of differentcolors were injected into a limb vein over 30 s on each day. After thelast microsphere injection, the dogs were killed, and lungs wereflushed free of blood, excised, dried at total lung capacity, and dicedinto ~2-cm³ pieces(n = 1,296-1,487 per dog).Relative blood flow to each piece on each day was determined byextracting the fluorescent dyes and determining the concentrations ofeach color. We established that blood flow is spatiallyheterogeneous with a coefficient of variation of 29.5 ± 2%. Blood flow to each piece is highly correlated with flow to thesame piece on all days (r = 0.930 ± 0.006). The temporal heterogeneity of regional perfusion as measured by the coefficient of variation is 6.9 ± 0.7% over the 5 days and is nonrandom. The magnitude of spatial and temporal variationis significantly less than previously reported in a study in whichanesthetized and mechanically ventilated dogs were used. We concludethat spatial distribution of pulmonary blood flowremains stable over days and we speculate that in the normal awake dogregional perfusion is determined primarily by a fixed structure such asthe geometry of the pulmonary vascular tree rather than by localvasoactive regulators. Anesthesia and/or mechanical ventilationmay increase the temporal variability in regionalperfusion.