Beta-adrenergic blockade in ponies with recurrent obstructive pulmonary disease

Ponies with recurrent airway obstruction have hyperresponsive airways during acute disease exacerbations but not during clinical remission. We examined the effect of beta-adrenergic blockade with propranolol on airway responsiveness to aerosol histamine in six ponies with recurrent airway obstruction and six age- and gender-matched controls. Measurements were made with principal ponies in clinical remission (period A) and during an acute period of airway obstruction (period B). beta-Adrenergic blockade did not change airway responsiveness, dynamic compliance (Cdyn), or pulmonary resistance (RL) in either group of ponies at period A or in the control ponies at period B. In principal ponies at period B, propranolol significantly increased RL but was without effect on Cdyn or airway responsiveness. We conclude that the beta-adrenergic system is involved in the control of central airway caliber in principal ponies at period B but that this system does not seem to be involved in the mechanism of airway hyperresponsiveness to histamine.     

Time-varying pulmonary arterial compliance

We tested the hypothesis that pulmonary arterial compliance (Ca) varies during the ventilatory cycle. Pressure and flow in the main pulmonary artery were measured in open-chest dogs under chloralose anesthesia (n = 12) with a positive-pressure volume-cycled ventilator. Input impedance was calculated from the pressure and flow waves of heart cycles obtained immediately after the start of inspiration (SI) and immediately after the start of expiration (SE). A lumped parameter model was used to calculate Ca from the input impedance spectrum of the main pulmonary artery. Three levels of positive end-expiratory pressure (PEEP) were used before and after meclofenamate (n = 6) or vagotomy (n = 6). Ca was significantly greater at SE than at SI at each level of PEEP. PEEP increased Ca at SE but not at SI. None of these changes was altered by meclofenamate or vagotomy, suggesting that these differences of Ca were due to passive mechanical effects rather than an active neurohumoral mechanisms. We conclude that Ca is time varying during the ventilatory cycle because it is altered by the dynamic increase of lung volume between SI and SE, but not with the quasi-static increase of lung volume induced by raising the level of PEEP. These changes of Ca were unaffected by vagal feedback or inhibition of cyclooxygenase. We suggest that the increased Ca just after the start of expiration may result from dynamic shifts of blood volume from the extra-alveolar to the alveolar vessels.     

Effect of gas density on dynamic pulmonary compliance.

We measured dynamic pulmonary compliance (Cdyn( in nine asymptomatic young men breathing gases of different density. When corrected for gas inertia, Cdyn was significantly lower during dense gas breathing (sulfur hexafluoride) than during air breathing. At higher breathing frequencies (60-90 breaths/min), Cdyn was greater on helium than on air. Static compliance was not different while breathing the three gas mixtures. These results may be explained by a density dependence of airways resistance in parallel lung units which contribute to frequency dependence of dynamic compliance. We conclude that most frequency-dependent behavior occurs among intraregional lung units subtended from airways between segmental bronchi and peripheral airways.     

Interrelations between pulmonary liquid volumes and lung compliance.

We have investigated the relative effects of lung edema and of increases in pulmonary blood volume (PBV) on lung compliance (CL), and also the effects of selective elevations of pulmonary arterial (Ppa) and left atrial (Pla) pressures on PBV and on CL, using an isolated, perfused, and ventilated rabbit lung preparation. Lung weight was continuously recorded. A step rise in Pla at constant flow caused a rapid rise in PBV accompanied by an immediate fall in CL. With maintained high vascular pressures interstitial edema accumulated with no further fall in CL. Not until 3 times the normal amount of extra-vascular fluid had accumulated did a further, secondary reduction in CL occur. When Ppa was elevated to the same level by 1) a rise in flow and 2) a rise in Pla, the latter type of experiment gave 3-5 times larger increases in PBV. Pla elevations with or without rise in Ppa (flow adjusted) gave almost the same rises in PBV. The fall in CL was related to rises in PBV regardless of how such rises were obtained. Our conclusion is that increases in PBV, but not accumulation of interstitial edema, reduced CL in this preparation.     

Alpha 1-adrenergic-induced airway obstruction in ponies with recurrent pulmonary disease

We examined the response of five ponies with recurrent airway obstruction (principals) and five age- and gender-matched controls to the aerosol alpha-adrenergic agonist phenylephrine after blockade with propranolol and atropine. Measurements were made with principal ponies in clinical remission (period A) and during acute airway obstruction (period B). The blockade had no effect on base-line pulmonary mechanics in control ponies during periods A and B or in the principal ponies during period A. However, in the principal ponies during period B, blockade increased dynamic compliance (Cdyn) and decreased pulmonary resistance (RL). Phenylephrine had no effect on the controls during either period. In the principals, phenylephrine decreased Cdyn and increased RL during both periods. The alpha 1-agonist aerosol prazosin shifted the phenylephrine dose-response curves to the right, but prasozin did not bronchodilate the principals during period B. This suggests that the role of alpha 1-adrenergic receptors in airway narrowing in ponies with recurrent airway obstruction is minimal. However, the response to phenylephrine in only the principal ponies suggests an increase in alpha-receptor numbers and/or activity in these animals compared with controls.     

Changes in compliance predict pulmonary morbidity in patients undergoing abdominal plication.

The incidence and severity of the effects of pulmonary compliance changes were investigated in patients undergoing abdominal plication surgery. A total of 20 healthy adults scheduled for abdominal plication surgery who had no significant history of pulmonary disease and 20 adults scheduled for nonabdominal, nonthoracic surgery (control group) underwent general endotracheal anesthesia; neuromuscular blockade was confirmed with electrical twitch monitoring. Before abdominal plication, the mean airway compliance was measured under total neuromuscular blockade at 33.4 +/- 2.1 ml/cm water, which was not significant when compared with control patient values. After abdominal plication was performed, the mean airway compliance was remeasured under total neuromuscular blockade; it was significantly decreased at 24.0 +/- 1.8 ml/cm water when compared with values for control patients (32.6 +/- 1.6 ml/cm) and with preplication values. Patients with airway compliance changes of less than 4 ml/cm water (when compared with preplication pulmonary mechanics) had far less incidence of atelectasis, requirements for supplemental oxygen at 24 hours or longer, or hypoxia when compared with patients with compliance changes of greater than 4 ml/cm water. Patients with compliance changes greater than 9 ml/cm water had the highest incidence of pulmonary morbidity. These data suggest that significant changes in pulmonary compliance occur after abdominal plication and that these airway compliance changes are associated with a clinically increased incidence of pulmonary morbidity in the postoperative period.     

Increased surface tension decreases pulmonary capillary volume and compliance.

Increased surface tension is an important component of several respiratory diseases, but its effects on pulmonary capillary mechanics are incompletely understood. We measured capillary volume and specific compliance before and after increasing surface tension with nebulized siloxane in excised dog lungs. The change in surface tension was sufficient to increase lung recoil 5 cm H(2)O at 50% total lung capacity. Increased surface tension decreased both capillary volume and specific compliance. The changes in capillary volume and compliance were greatest at the lung volumes at which the surface tension change was greatest. Near functional residual capacity, capillary volume postsiloxane was approximately 30% of control. Presiloxane capillary specific compliance was approximately 7%/cm H(2)O near functional residual capacity and approximately 2.5%/cm H(2)O near total lung capacity. Postsiloxane capillary-specific compliance was 3%/cm H(2)O, and was independent of lung volume. We conclude that in addition to their well-known effects on lung mechanics, changes in surface tension also have important effects on capillary mechanics. We speculate that these changes may in turn affect ventilation and perfusion, worsen gas exchange, and alter leukocyte sequestration.     

Attenuated Hering-Breuer inflation reflex 4 years after pulmonary vagal denervation in ponies

The purpose of this study was to determine whether there was any recovery of the Hering-Breuer inflation reflex in ponies between 2-4 wk and 3-4 yr after hilar nerve denervation (HND). Under anesthesia and before HND, airway occlusion after a 3-liter lung inflation lengthened the subsequent occluded breath by nearly 10 times the control breath duration. Between 2 wk and 3-4 yr after HND, this maneuver increased the duration of the occluded breath by only 2.5 times the control breath duration. Also under anesthesia, the airway was occluded at end expiration. This maneuver increased the duration of the subsequent inspiratory effort by 71% in hilar nerve intact ponies but by only 20-25% 2-4 wk and 3-4 yr after HND. For both tests, the pre- and post-HND differences were statistically significant (P less than 0.05), but there were no significant differences (P greater than 0.10) between 2-4 wk and 3-4 yr post-HND. In awake ponies, at rest and during mild and moderate treadmill exercise, breathing frequency was generally lower and inspiratory time was greater after relative to before HND. The inspiratory time-to-total cycle duration ratio was consistently increased by 0.10-0.15 after HND (P less than 0.05). There was no significant change in this ratio between 2-4 wk and 3-4 yr post-HND (P greater than 0.10). We conclude that the surgical procedure for HND used in this study does not permit any significant reinnervation, and there are no significant changes within the ventilatory control system to compensate for loss of hilar nerve afferents.     

Anatomic distribution of pulmonary vascular compliance

Presson, Robert G., Jr., Said H. Audi, Christopher C. Hanger, Gerald M. Zenk, Richard A. Sidner, John H. Linehan, Wiltz W. Wagner, Jr., and Christopher A. Dawson. Anatomic distribution ofpulmonary vascular compliance. J. Appl.Physiol. 84(1): 303-310, 1998.Previously, thepressure changes after arterial and venous occlusion have been used tocharacterize the longitudinal distribution of pulmonary vascularresistance with respect to vascular compliance using compartmentalmodels. However, the compartments have not been defined anatomically.Using video microscopy of the subpleural microcirculation, we havemeasured the flow changes in ~40-µm arterioles and venules aftervenous, arterial, and double occlusion maneuvers. The quasi-steadyflows through these vessels after venous occlusion permitted anestimation of the compliance in three anatomic segments: arteries >40µm, veins >40 µm, and vessels <40 µm in diameter. We foundthat ~65% of the total pulmonary vascular compliance was in vessels<40 µm, presumably mostly capillaries. The transient portions ofthe pressure and flow data after venous, arterial, and double occlusionwere consistent with most of the arterial compliance being upstreamfrom most of the arterial resistance and most of the venous compliancebeing downstream from most of the venous resistance.

     

Surface tension and pulmonary compliance in premature rabbits

In vitro surface properties of pulmonary surfactant thought to be essential to its ability to increase pulmonary compliance include minimum surface tension less than 10 dyn/cm and large surface tension variability and hysteresis. We tested four surface-active agents (Tween 20, a detergent; and FC-100, FC-430, and FC-431, industrial fluorocarbons), all lacking these properties, for their ability to increase pulmonary compliance in surfactant-deficient premature rabbits. Fetal rabbits were delivered by cesarean section at 27 days (full term = 31 days) and injected via tracheostomy with 50% lactated Ringer solution, adult rabbit surfactant, or one of the four experimental agents. Dynamic compliance was measured using 1 h of mechanical ventilation followed by alveolar lavage. Each experimental agent produced a dynamic compliance significantly higher than 50% lactated Ringer solution and statistically equal to or greater than natural surfactant. Equilibrium surface tension of the agents and minimum and equilibrium surface tension of the alveolar washes each correlated with compliance (P less than 0.05). This suggests that some surface properties of pulmonary surfactant believed to be essential are not, although surface tension does seem to play a role in pulmonary compliance.     

Role of carotid chemoreceptors and pulmonary vagal afferents during helium-oxygen breathing in ponies

Our purpose was to assess compensatory breathing responses to airway resistance unloading in ponies. We hypothesized that the carotid bodies and hilar nerve afferents, respectively, sense chemical and mechanical changes caused by unloading, hence carotid body-denervated (CBD) and hilar nerve-denervated ponies (HND) might demonstrate greater ventilatory responses when decreasing resistance. At rest and during treadmill exercise, resistance was transiently reduced approximately 40% in five normal, seven CBD, and five HND ponies by breathing gas of 79% He-21% O2 (He-O2). In all groups at rest, He-O2 breathing did not consistently change ventilation (VE), breathing frequency (f), tidal volume (VT), or arterial PCO2 (PaCO2) from room air-breathing levels. During treadmill exercise at 1.8 mph-5% grade in normal and HND ponies, He-O2 breathing did not change PaCO2 but at moderate (6 mph-5% grade), and heavy (8 mph-8% grade) work loads, absolute PaCO2 tended to decrease by 1 min of resistance unloading. delta PaCO2 calculated as room air minus He-O2 breathing levels at 1 min demonstrated significant changes in PaCO2 during exercise resistance unloading (P less than 0.05). No difference between normal and HND ponies was found in exercise delta PaCO2 responses (P greater than 0.10); however, in CBD ponies, the delta PaCO2 during unloading was greater at any given work load (P less than 0.05), suggesting finer regulation of PaCO2 in ponies with intact carotid bodies. During heavy exercise VE and f increased during He-O2 breathing in all three groups of ponies (P less than 0.05), although there were no significant differences between groups (P greater than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)     

Local control of pulmonary resistance and lung compliance in the canine lung.

Local control of pulmonary resistance and lung compliance was studied in the in situ left lower lobe of the canine lung. Recirculation of blood through the lobe while the Pco2 of the ventilatory gas was varied resulted in an increase in resistance and a decrease in compliance only when the pulmonary venous pH was greater than 7.42. Alternating sodium bicarbonate and lactic acid infusion while alveolar Pco2 was maintained below 5 mmHg demonstrated the dependence of the hypocapnic response on the acid-base status of the blood perfusing the respiratory airways. The increase in resistance and decrease in compliance observed at a pulmonary venous pH of 7.64 was comparable to that observed after lobar pulmonary artery occlusion. Varying degrees of hypoxia did not significantly affect bronchomotor tone, nor was the bronchoconstriction following lobar pulmonary artery occlusion affected by the hypoxia. Vagal stimulation superimposed on a stepwise increase in pulmonary venous pH from 7.32 to 7.62 resulted in an increase in resistance which paralleled the increase in resistance when pulmonary venous pH alone was increased. Compliance was not significantly affected by vagal stimulation at any level of pulmonary venous pH.     

Hypoventilation in ponies after carotid body denervation.

Seven ponies were subjected to carotid body denervation (CD) and two ponies were sham operated (S). Measurement of arterial blood gases and arterial blood and cerebrospinal fluid (CSF) acid-base balance were made prior to and 1,2,4,9, and 17 wks after surgery in unanesthetized animals. Resting ventilation and ventilatory responsiveness to hypoxia and NaCN infusion were assessed prior to and 2,9, and 17 wks after surgery. Alveolar hypoventilation in the CD ponies was marked 1-2 wk after surgery when VE and VA were reduced 40% and 10%, respectively, from control and PaCO2 was 12-15 mmHg above control. However, the effect was not nearly as great 4, 9, and 17 wk after surgery when the PaCO2 stabilized at approximately 6 mmHg above control PaCO2. Arterial blood pH was normal in the hypercapnic CD ponies, but CSF pH remained acid relative to normal throughout the 17-wk period. Changes in ventilatory responsiveness to hypoxia and NaCN tended to parallel changes in resting ventilation. These findings suggest: 1) the carotid bodies are essential in ponies to maintain normal ventilation: 2) in CD ponies peripheral chemosensitivity is partially regained at some unestablished locus; and 3) pH compensating mechanisms in chronically hypercapnic ponies function relatively better in blood than in CSF.     

Pulmonary blood flow distribution in anesthetized ponies.

Results of recent investigations in humans and dogs indicate that gravity-independent factors may be important in determining the distribution of pulmonary blood flow. To further evaluate the role of gravity-independent factors, pulmonary blood flow distribution was examined using 15-microns radionuclide-labeled microspheres in five prone ponies over 5 h of pentobarbital sodium anesthesia. The ponies were killed, and the lungs were excised and dried by air inflation (pressure 45 cmH2O). The dry lungs were cut into transverse slices 1-2 cm thick along the dorsal-ventral axis, parallel to gravity. Radioactivity of pieces cut from alternate slices was measured with a gamma well counter. The main finding was a preferential distribution of pulmonary blood flow to dorsal-caudal regions and higher flow in the center of each lung slice when compared with the slice periphery. Flow was lowest in cranial and ventral areas. Differences of +/- 2 SD were observed between core and peripheral blood flow. No medial-lateral differences were found. Pulmonary blood flow distribution did not change over 5 h of anesthesia, and the basic flow pattern was not different in the left vs. right lung. These results suggest that in the intact prone mechanically ventilated pony (inspired O2 fraction greater than or equal to 0.95) factors other than gravity are primary determinants of pulmonary blood flow.