Redistribution of pulmonary blood flow during unilateral hypoxia in prone and supine dogs

We usedfluorescent-labeled microspheres in pentobarbital-anesthetized dogs tostudy the effects of unilateral alveolar hypoxia on the pulmonary bloodflow distribution. The left lung was ventilated with inspiredO₂ fraction of 1.0, 0.09, or 0.03 in random order; the right lung was ventilated with inspiredO₂ fraction of 1.0. The lungs wereremoved, cleared of blood, dried at total lung capacity, then cubed toobtain ~1,500 small pieces of lung (~1.7 cm³). The coefficient ofvariation of flow increased (P < 0.001) in the hypoxic lung but was unchanged in the hyperoxic lung.Most (70-80%) variance in flow in the hyperoxic lung wasattributable to structure, in contrast to only 30-40% of thevariance in flow in the hypoxic lung(P < 0.001). When adjusted for thechange in total flow to each lung, 90-95% of the variance in thehyperoxic lung was attributable to structure compared with 70-80%in the hypoxic lung (P < 0.001). Thehilar-to-peripheral gradient, adjusted for change in total flow,decreased in the hypoxic lung (P = 0.005) but did not change in the hyperoxic lung. We conclude thathypoxic vasoconstriction alters the regional distribution of flow inthe hypoxic, but not in the hyperoxic, lung.

     

Effects of emphysema on diaphragm blood flow during exercise

Chronichyperinflation of the lung in emphysema displaces the diaphragmcaudally, thereby placing it in a mechanically disadvantageous positionand contributing to the increased work of breathing. We tested thehypothesis that total and regional diaphragm blood flows are increasedin emphysema, presumably reflecting an increased diaphragm energeticdemand. Male Syrian Golden hamsters were randomly divided intoemphysema (E; intratracheal elastase 25 units/100 g body wt) andcontrol (C; saline) groups, and experiments were performed 16-20wk later. The regional distribution of blood flow withinthe diaphragm was determined by using radiolabeled microspheres inhamsters at rest and during treadmill exercise (walking at 20 feet/min,20% grade). Consistent with pronounced emphysema, lung volume per unitbody weight was greater in E hamsters (C, 59.3 ± 1.8; E, 84.5 ± 5.0 ml/kg; P < 0.001) and arterialPO₂ was lower both at rest (C, 74 ± 3; E, 59 ± 2 Torr; P < 0.001) and during exercise (C, 93 ± 3; E, 69 ± 4 Torr; P < 0.001). At rest, total diaphragm blood flow was not different between C and Ehamsters (C, 47 ± 4; E, 38 ± 4 ml · min¹ · 100 g¹;P = 0.18). In both C and E hamsters,blood flow at rest was lower in the ventral costal region of thediaphragm than in the dorsal and medial costal regions and the cruraldiaphragm. During exercise in both C and E hamsters, blood flowsincreased more in the dorsal and medial costal regions and in thecrural diaphragm than in the ventral costal region. Total diaphragmblood flow was greater in E hamsters during exercise (C, 58 ± 7; E,90 ± 14 ml · min¹ · 100 g¹;P = 0.03), as a consequence ofsignificantly higher blood flows in the medial and ventral costalregions and crural diaphragm. In addition, exercise-induced increasesin intercostal (P < 0.005) andabdominal (P < 0.05) muscle bloodflows were greater in E hamsters. The finding that diaphragm blood flowwas greater in E hamsters during exercise supports the contention thatemphysema increases the energetic requirements of the diaphragm.

     

Myosin molecular motor dysfunction in dystrophic mouse diaphragm

Cross-bridge properties and myosin heavy chain (MHC) compositionwere investigated in isolated diaphragm from 6-mo-old control (n = 12) andmdx(n = 12) mice. Compared with control,peak tetanic tension fell by 50% inmdx mice(P < 0.001). The total number ofcross bridges per square millimeter(×10⁹), the elementaryforce per cross bridge, and the peak mechanical efficiency were lowerin mdx than in control mice (eachP < 0.001). The duration of thecycle and the rate constant for cross-bridge detachment weresignificantly lower in mdx than incontrol mice. In the overall population, there was a linearrelationship between peak tetanic tension and either total number ofcross bridges per square millimeter or elementary force per crossbridge (r = 0.996 andr = 0.667, respectively, eachP < 0.001). Themdx mice presented a higher proportionof type IIA MHC (P < 0.001) thancontrol mice and a reduction in type IIX MHC(P < 0.001) and slowmyosin isoforms (P < 0.01) comparedwith control mice. We concluded that, inmdx mice, impaired diaphragm strengthwas associated with qualitative and quantitative changes in myosin molecular motors. It is proposed that reduced force generated per crossbridge contributed to diaphragm weakness inmdx mice.

     

Partial liquid ventilation protects lung during resuscitation from shock

Younger, John G., Ali S. Taqi, Gerd O. Till, and Ronald B. Hirschl. Partial liquid ventilation protects lung during resuscitation from shock. J. Appl.Physiol. 83(5): 1666-1670, 1997.Preliminaryanimal experience with partial liquid ventilation (PLV) suggests thatthis therapy may diminish neutrophil invasion and capillary leak duringacute lung injury. We sought to confirm these findings in a model ofshock-induced lung injury. Sixty anesthetized rats were studied. Afterhemorrhage to an arterial pressure of 25 mmHg for 45 min, animals wereresuscitated with blood and saline and treated with gas ventilationalone or with 5 ml/kg of intratracheally administered perflubron.Myeloperoxidase activity was used to measure lung neutrophil content. Apermeability index (the bronchoalveolar-to-blood ratio of¹²⁵I-labeled albumin activity)quantified alveolar leak. Injury caused an increase in myeloperoxidasethat was reversed by PLV (injury = 0.837 ± 0.452, PLV = 0.257 ± 0.165; P < 0.01). Capillary permeability also increased withhemorrhage, with a strong trend toward improvement in the PLV group(permeability indexes: injury = 0.094 ± 0.102, PLV = 0.045 ± 0.045; 95% confidence interval for injury  PLV: 0.024,0.1219). We conclude that PLV is associated with a decrease inpulmonary neutrophil accumulation and a trend toward decreased capillary leak after hemorrhagic shock.

     

High-frequency partial liquid ventilation in respiratory distress syndrome: hemodynamics and gas exchange

Sukumar, Minakshi, Mahesh Bommaraju, John E. Fisher,Frederick C. Morin III, Michele C. Papo, Bradley P. Fuhrman, Lynn J. Hernan, and Corinne Lowe Leach. High-frequency partial liquidventilation in respiratory distress syndrome: hemodynamics and gasexchange. J. Appl. Physiol. 84(1):327-334, 1998.Partial liquid ventilation using conventionalventilatory schemes improves lung function in animal models ofrespiratory failure. We examined the feasibility of high-frequencypartial liquid ventilation in the preterm lamb with respiratorydistress syndrome and evaluated its effect on pulmonary and systemichemodynamics. Seventeen lambs were studied in three groups:high-frequency gas ventilation (Gas group), high-frequency partialliquid ventilation (Liquid group), and high-frequency partial liquidventilation with hypoxia-hypercarbia (Liquid-Hypoxiagroup). High-frequency partial liquid ventilation increased oxygenation compared with high-frequency gas ventilation over5 h (arterial oxygen tension 253 ± 21.3 vs. 17 ± 1.8 Torr; P < 0.001).Pulmonary vascular resistance decreased 78%(P < 0.001), pulmonary blood flowincreased fivefold (P < 0.001), andaortic pressure was maintained (P < 0.01) in the Liquid group, in contrast to progressive hypoxemia,hypercarbia, and shock in the Gas group. Central venouspressure did not change. The Liquid-Hypoxia group was similar tothe Gas group. We conclude that high-frequency partial liquidventilation improves gas exchange and stabilizes pulmonary and systemichemodynamics compared with high-frequency gas ventilation. Thestabilization appears to be due in large part to improvement in gasexchange.

     

Postnatal lung function and protein permeability after fetal or maternal corticosteroids in preterm lambs

Rebello, Celso M., Machiko Ikegami, M. Gore Ervin, Daniel H. Polk, and Alan H. Jobe. Postnatal lung function and protein permeability after fetal or maternal corticosteroids in preterm lambs.J. Appl. Physiol. 83(1): 213-218, 1997.We evaluated postnatal lung function andintravascular albumin loss to tissues of 123-days-gestation pretermsurfactant-treated and ventilated lambs 15 h after direct fetal(n = 8) or maternal(n = 9) betamethasone treatment orsaline placebo (n = 9). Thebetamethasone-treated groups had similar increases in dynamiccompliances, ventilatory efficiency indexes, and lung volumes relativeto controls (P < 0.05). The lossesof ¹²⁵I-labeled albumin fromblood, a marker of intravascular integrity, and the recoveries of¹²⁵I-albumin in muscle and brainwere similar for control and betamethasone-exposed lambs.Betamethasone-treated lambs had lower recoveries of¹²⁵I-albumin in lung tissues andin alveolar washes than did controls (P < 0.01). Although blood pressureswere higher for the treated groups (P < 0.05), all groups had similar blood volumes, cardiac outputs, andorgan blood flows. Maternal or fetal treatment with betamethasone 15 hbefore preterm delivery equivalently improved postnatal lung function,reduced albumin recoveries in lungs, and increased blood pressures.However, prenatal betamethasone had no effects on the systemicintravascular losses of albumin or did not change blood volumes.

     

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.

     

Diaphragmatic lipid peroxidation in chronically loaded rats

Recent workindicates that free radical-mediated lipid peroxidation takes placewithin the diaphragm on strenuous contraction. This phenomenon has onlybeen demonstrated using fairly artificial experimental models and hasnot been studied during the type of sustained respiratory loadingtypically seen in patients with lung disease. The purpose of thepresent study was to measure the levels of several biochemical markersof protein oxidation (protein carbonyl levels) and lipid peroxidation(8-isoprostane, reduced glutathione, and oxidized glutathione levels)in diaphragms of rats subjected to chronic respiratory loading.Respiratory loading was accomplished by tracheal banding; groups ofanimals were loaded for 4, 8, or 12 days, and a group of sham-operated unloaded animals was used as controls. After loading, animals werekilled, diaphragm contractility was assessed in vitro by using aportion of the excised diaphragm, and the remaining diaphragm and thesoleus muscles were used for biochemical analysis. We found diminishedforce generation in diaphragms from all groups of banded animalscompared with muscles from controls. For example, twitch force averaged7.8 ± 0.8 (SE) N/cm² inunloaded animals and 4.0 ± 0.4, 3.0 ± 0.4, and 3.4 ± 0.4 N/cm² in animals loaded for 4, 8, and 12 days, respectively (P < 0.0001). Loading also elicited increases in diaphragmatic proteincarbonyl concentrations (P < 0.001),and the time course of alterations in carbonyl levels paralleledloading-induced alterations in the diaphragm force-frequencyrelationship. Although loading was also associated with increases indiaphragmatic 8-isoprostane levels (P < 0.003) and reductions in diaphragm reduced glutathione levels (P < 0.003), the time course ofchanges in these latter parameters did not correspond to alterations inforce. Soleus glutathione and carbonyl levels were not altered bybanding. We speculate that respiratory loading-induced alterations indiaphragmatic force generation may be related to free radical-mediatedprotein oxidation, but not to free radical-induced lipid peroxidation.     

Diaphragm thickening during inspiration

Cohn, David, Joshua O. Benditt, Scott Eveloff, and F. DennisMcCool. Diaphragm thickening during inspiration.J. Appl. Physiol. 83(1): 291-296, 1997.Ultrasound has been used to measure diaphragm thickness(T_di) in thearea where the diaphragm abuts the rib cage (zone of apposition).However, the degree of diaphragm thickening during inspiration reportedas obtained by one-dimensional M-mode ultrasound was greater than thatpredicted by using other radiographic techniques. Becausetwo-dimensional (2-D) ultrasound provides greater anatomic definitionof the diaphragm and neighboring structures, we used this technique toreevaluate the relationship between lung volume andT_di. We firstestablished the accuracy and reproducibility of 2-D ultrasound bymeasuring T_diwith a 7.5-MHz transducer in 26 cadavers. We found thatT_di measured byultrasound correlated significantly with that measured by ruler (R² = 0.89), withthe slope of this relationship approximating a line of identity(y = 0.89x + 0.04 mm). The relationship between lung volume andT_di was thenstudied in nine subjects by obtaining diaphragm images at the fivetarget lung volumes [25% increments from residual volume (RV) tototal lung capacity (TLC)]. Plots ofT_di vs. lungvolume demonstrated that the diaphragm thickened as lung volumeincreased, with a more rapid rate of thickening at the higher lungvolumes[T_di = 1.74 vital capacity (VC)² + 0.26 VC + 2.7 mm] (R² = 0.99; P < 0.001) where lung volumeis expressed as a fraction of VC. The mean increase inT_di between RVand TLC for the group was 54% (range 42-78%). We conclude that2-D ultrasound can accurately measureT_di and that theaverage thickening of the diaphragm when a subject is inhaling from RVto TLC using this technique is in the range of what would be predictedfrom a 35% shortening of the diaphragm.

     

Pulmonary vagal innervation is required to establish adequate alveolar ventilation in the newborn lamb

To investigate the effects of bilateralintrathoracic vagotomy on the establishment of continuous breathing andeffective gas exchange at birth, we studied 8 chronically instrumented, unanesthetized, sham-operated and 14 vagotomized newborn lambs after aspontaneous, unassisted vaginal delivery. Fetal lambs wereinstrumented in utero to record sleep states, diaphragmatic electromyogram, blood pressure, arterial pH, and blood-gas tensions. Six of eight sham-operated lambs established effective gas exchange within 10 min of birth, whereas 12 of 14 vagotomized animals developed respiratory acidosis and hypoxemia (P = 0.008). Breathing frequency in vagotomized newborns was significantlylower during the entire postnatal period compared with sham-operatednewborns. Vagotomized subjects also remained hypothermic during theentire postnatal period (P < 0.05).Bronchoalveolar lavage indicated an increased minimum surface tension,whereas lung histology showed perivascular edema and partialatelectasis in the vagotomized group. We conclude that stimulation ofbreathing and effective gas exchange are critically dependent on intactvagal nerves during the transition from fetal to neonatallife.

     

Voluntary activation of the human diaphragm in health and disease

Intersubjectcomparison of the crural diaphragm electromyogram, as measured by anesophageal electrode, requires a reliable means for normalizing thesignal. The present study set out 1) to evaluate which voluntary respiratory maneuvers provide high andreproducible diaphragm electromyogram root-mean-square (RMS) values and2) to determine the relativediaphragm activation and mechanical and ventilatory outputs duringbreathing at rest in healthy subjects(n = 5), in patients with severechronic obstructive pulmonary disease (COPD,n = 5), and in restrictive patientswith prior polio infection (PPI, n = 6). In all groups, mean voluntary maximal RMS values were higher duringinspiration to total lung capacity than during sniff inhalation throughthe nose (P = 0.035, ANOVA). The RMS(percentage of voluntary maximal RMS) during quiet breathing was 8% inhealthy subjects, 43% in COPD patients, and 45% in PPI patients.Despite the large difference in relative RMS(P = 0.012), there were no differencesin mean transdiaphragmatic pressure (P = 0.977) and tidal volumes (P = 0.426). We conclude that voluntary maximal RMS is reliably obtainedduring an inspiration to total lung capacity but a sniff inhalationcould be a useful complementary maneuver. Severe COPD and PPI patientsbreathing at rest are characterized by increased diaphragm activationwith no change in diaphragm pressure generation.

     

Modeling diffusion limitation of gas exchange in lungs containing perfluorocarbon

We reportedchanges in alveolar-arterial PO₂ gradient,ventilation-perfusion heterogeneity, and arterial-alveolarPCO₂ gradient during partial liquid ventilation(PLV) in healthy piglets (E. A. Mates, P. Tarczy-Hornoch, J. Hildebrandt, J. C. Jackson, and M. P. Hlastala. In: OxygenTransport to Tissue XVII, edited by C. Ince. New York: Plenum,1996, vol. 388, p. 585-597). Here we develop two mathematicalmodels to predict transient and steady-state (SS) gas exchangeconditions during PLV and to estimate the contribution of diffusionlimitation to SS arterial-alveolar differences. In the simplest model,perfluorocarbon is represented as a uniform flat stirred layer and, ina more complex model, as an unstirred spherical layer in a ventilatedterminal alveolar sac. Time-dependent solutions of both models showthat SS is established for various inert and respiratory gases within5-150 s. In fluid-filled unventilated terminal units, all times toSS increased sometimes by hours, e.g., SF₆ exceeded 4 h. SSsolutions for the ventilated spherical model predicted minorend-capillary disequilibrium of inert gases and significantdisequilibrium of respiratory gases, which could explain a largeportion of the arterial-alveolar PCO₂ gradient measured during PLV (14). We conclude that, during PLV, diffusion gradients for gases are generally small, except for CO₂.

     

Pulmonary blood flow distribution has a hilar-to-peripheral gradient in awake, prone sheep

Walther, Sten M., Karen B. Domino, Robb W. Glenny, Nayak L. Polissar, and Michael P. Hlastala. Pulmonary blood flow distribution has a hilar-to-peripheral gradient in awake, prone sheep.J. Appl. Physiol. 82(2): 678-685, 1997.We examined the pulmonary blood flow distribution withintravenous fluorescent microspheres (15 µm) in nine prone,unanesthetized, lambs. Lungs flushed free of blood were air-dried attotal lung capacity and sectioned into~2-cm³ pieces. The pieces wereweighed, identified by lobe, and assigned spatial coordinates.Fluorescence was read on a spectrophotometer, and signals werecorrected for piece weight and normalized to mean flow. Pulmonary bloodflow heterogeneity was assessed by using the coefficient of variationof the flow data. The number of pieces (±SD) analyzed were 1,249 ± 150/animal. Heterogeneity of blood flow was 29.5 ± 6.5%(coefficient of variation = SD/mean). Pulmonary blood flow decreasedwith distance from hilus (P < 0.002) but did not change significantly with vertical height. Distance fromthe hilus was the best predictor of pulmonary blood flow (R² = 0.201) and,together with spatial coordinates and lobe, accounted for 33.7 ± 12.0% of blood flow variability. We conclude that pulmonary blood flowin the awake, prone sheep is distributed with a hilar-to-peripheral gradient but no significant vertical gradient.

     

Prolonged exercise increases peripheral plasma ACTH, CRH, and AVP in male athletes

We wished to determine whether the increased ACTH duringprolonged exercise was associated with changes in peripheralcorticotropin-releasing hormone (CRH) and/or argininevasopressin (AVP). Six male triathletes were studied during exercise: 1 h at 70% maximal oxygen consumption, followed by progressivelyincreasing work rates until exhaustion. Data obtained during theexercise session were compared with a nonexercise control session.Venous blood was sampled over a 2-h period for cortisol, ACTH, CRH,AVP, renin, glucose, and plasma osmolality. There were significantincreases by ANOVA on log-transformed data in plasma cortisol(P = 0.002), ACTH(P < 0.001), CRH(P < 0.001), and AVP(P < 0.03) during exercise comparedwith the control day. A variable increase in AVP was observed after the period of high-intensity exercise. Plasma osmolality rose with exercise(P < 0.001) and was related toplasma AVP during submaximal exercise(P < 0.03) but not with theinclusion of data that followed the high-intensity exercise. Thisindicated an additional stimulus to the secretion of AVP. The mechanismby which ACTH secretion occurs during exercise involves both CRH andAVP. We hypothesize that high-intensity exercise favors AVP release andthat prolonged duration favors CRH release.

     

Effects of renal denervation on cardiovascular and renal responses to ACE inhibition in conscious lambs

Smith, Francine G., Suzanne Chan, and Saskia N. De Wildt.Effects of renal denervation on cardiovascular and renal responsesto ACE inhibition in conscious lambs. J. Appl.Physiol. 83(2): 414-419, 1997.Cardiovascular andrenal effects of either the angiotensin-converting enzyme inhibitorcaptopril or vehicle were measured in chronically instrumented lambs inthe presence (intact; n = 6) andabsence of renal sympathetic nerves (denervated; n = 5) to determine whether there wasan interaction between the renin-angiotensin system and renalsympathetic nerves early in life. Captopril caused a similar decreasein mean arterial pressure (P < 0.001) in intact and denervated lambs, predominantly through a decreasein diastolic pressure. Heart rate was increased from 177 ± 34 to213 ± 22 (SD) beats/min during captopril compared with vehicleinfusion in intact lambs. In denervated lambs, basal heart rates wereelevated to 218 ± 33 beats/min; there was no further increase inheart rate during captopril compared with vehicle infusion. Captoprilinfusion caused a decrease in renal vascular resistance but only in theabsence of renal nerves. These findings provide evidence to suggestthat early in life there is an interaction between renal sympatheticnerves and the renin-angiotensin system in regulating renalhemodynamics and the baroreflex control of the heart.

     

Aerosol probes of lung injury in a 28-wk longitudinal study of mild experimental emphysema in dogs

After baseline measurements of lung mechanics,effective air space diameter (EAD), and aerosol dispersion (AD), threedogs were exposed to two treatments of aerosolized papain (3 ml of a4% solution), and measurements were repeated during a 28-wk follow-upperiod. EAD and AD were measured with boluses of 0.7-µm particles ofdi-2-ethylhexl sebacate, with Pen (i.e., volumetric boluspenetration/total lung capacity) between 0.1 and 0.4. After papainexposure, EAD increased a mean of 28%(P < 0.0001) and AD (Pen = 0.3, 0.4)increased 4-7% (P < 0.03). Theprogression of injury was indicated by increasing trends in total lungcapacity (P < 0.05), residual volume(P < 0.05), and EAD(P = 0.06) through week 18. There was no evidence ofdisease progression between weeks 18 and 28, whereas some of the data forindividual dogs suggested partial recovery from lung injury atweek 28. The results show that aerosolprobes can detect and characterize mild lung injury in experimental emphysema.     

Nitric oxide decreases lung liquid production in fetal lambs

Cummings, James J. Nitric oxide decreases lung liquidproduction in fetal lambs. J. Appl.Physiol. 83(5): 1538-1544, 1997.To examine theeffect of nitric oxide on fetal lung liquid production, I measured lungliquid production in fetal sheep at 130 ± 5 days gestation (range122-137 days) before and after intrapulmonary instillation ofnitric oxide. Thirty-one studies were done in which net lung luminalliquid production (Jv) was measured by plotting the change in lung luminal liquid concentration ofradiolabeled albumin, an impermeant tracer that was mixed into the lungliquid at the start of each study. To see whether changes inJvmight be associated with changes in pulmonary hemodynamics, pulmonary and systemic pressures were measured and left pulmonary arterial flowwas measured by an ultrasonic Doppler flow probe. Variables weremeasured during a 1- to 2-h control period and for 4 h after a smallbolus of isotonic saline saturated with nitric oxide gas (10 or 100%)was instilled into the lung liquid. Control (saline) instillations(n = 6) caused no change in anyvariable over 6 h. Nitric oxide instillation significantly decreasedJv and increased pulmonary blood flow;these effects were sustained for 1-2 h. There was also asignificant but transient decrease in pulmonary arterial pressure. Thusintrapulmonary nitric oxide causes a significant decrease in lungliquid and is associated with a decrease in pulmonary vascularresistance. In a separate series of experiments either amiloride orbenzamil, which blocks Na⁺transport, was mixed into the lung liquid before nitric oxide instillation; still, there was a similar reduction in lung liquid production. Thus the reduction in lung liquid secretion caused bynitric oxide does not appear to depend on apicalNa⁺ efflux.

     

Task failure with lack of diaphragm fatigue during inspiratory resistive loading in human subjects

McKenzie, D. K., G. M. Allen, J. E. Butler, and S. C. Gandevia. Task failure with lack of diaphragm fatigue during inspiratory resistive loading in human subjects. J. Appl. Physiol. 82(6): 2011-2019, 1997.Taskfailure during inspiratory resistive loading is thought to beaccompanied by substantial peripheral fatigue of the inspiratorymuscles. Six healthy subjects performed eight resistive breathingtrials with loads of 35, 50, 75 and 90% of maximal inspiratorypressure (MIP) with and without supplemental oxygen. MIP measuredbefore, after, and at every minute during the trial increased slightlyduring the trials, even when corrected for lung volume (e.g., for 24 trials breathing air, 12.5% increase, P < 0.05). In some trials, taskfailure occurred before 20 min (end point of trial), and in thesetrials there was an increase in end-tidalPCO₂(P < 0.01), despite the absence of peripheral muscle fatigue. In four subjects (6 trials with task failure), there was no decline in twitch amplitude with bilateral phrenic stimulation or in voluntary activation of the diaphragm, eventhough end-tidal PCO₂ rose by 1.6 ± 0.9%. These results suggest that hypoventilation,CO₂ retention, and ultimate taskfailure during resistive breathing are not simply dependent on impairedforce-generating capacity of the diaphragm or impaired voluntaryactivation of the diaphragm.

     

Ultrasound Doppler estimates of femoral artery blood flow during dynamic knee extensor exercise in humans

Rådegran, G. Ultrasound Dopplerestimates of femoral artery blood flow during dynamic knee extensorexercise in humans. J. Appl. Physiol.83(4): 1383-1388, 1997.Ultrasound Doppler has been used tomeasure arterial inflow to a human limb during intermittent staticcontractions. The technique, however, has neither been thoroughlyvalidated nor used during dynamic exercise. In this study, the inherentproblems of the technique have been addressed, and the accuracy wasimproved by storing the velocity tracings continuously and calculatingthe flow in relation to the muscle contraction-relaxation phases. Thefemoral arterial diameter measurements were reproducible with a meancoefficient of variation within the subjects of 1.2 ± 0.2%. Thediameter was the same whether the probe was fixed or repositioned atrest (10.8 ± 0.2 mm) or measured during dynamic exercise. The bloodvelocity was sampled over the width of the diameter and the parabolicvelocity profile, since sampling in the center resulted in anoverestimation by 22.6 ± 9.1% (P < 0.02). The femoral arterial Doppler blood flow increased linearly(r = 0.997, P < 0.001) with increasing load [Doppler blood flow = 0.080 · load (W) + 1.446 l/min] and was correlated positively with simultaneousthermodilution venous outflow measurements(r = 0.996, P < 0.001). The two techniques werelinearly related (Doppler = thermodilution · 0.985 + 0.071 l/min; r = 0.996, P < 0.001), with a coefficient ofvariation of ~6% for both methods.

     

Prostaglandin production contributes to exercise-induced vasodilation in heart failure

Lang, Chim C., Don B. Chomsky, Javed Butler, Shiv Kapoor,and John R. Wilson. Prostaglandin production contributes toexercise-induced vasodilation in heart failure. J. Appl. Physiol. 83(6): 1933-1940, 1997.Endothelial release of prostaglandins may contribute toexercise-induced skeletal muscle arteriolar vasodilation in patientswith heart failure. To test this hypothesis, we examined the effect ofindomethacin on leg circulation and metabolism in eight chronic heartfailure patients, aged 55 ± 4 yr. Central hemodynamics and legblood flow, determined by thermodilution, and leg metabolic parameterswere measured during maximum treadmill exercise before and 2 h afteroral administration of indomethacin (75 mg). Leg release of6-ketoprostaglandin F₁ was alsomeasured. During control exercise, leg blood flow increased from 0.34 ± 0.03 to 1.99 ± 0.19 l/min(P < 0.001), legO₂ consumption from 13.6 ± 1.8 to 164.5 ± 16.2 ml/min (P < 0.001), and leg prostanoid release from 54.1 ± 8.5 to267.4 ± 35.8 pg/min (P < 0.001).Indomethacin suppressed release of prostaglandinF₁(P < 0.001) throughout exercise anddecreased leg blood flow during exercise(P < 0.05). This was associated witha corresponding decrease in leg O₂ consumption (P < 0.05) and a higher level offemoral venous lactate at peak exercise(P < 0.01). These data suggest thatrelease of vasodilatory prostaglandins contributes to skeletal musclearteriolar vasodilation in patients with heart failure.