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.

     

Anatomically based finite element models of the human pulmonary arterial and venous trees including supernumerary vessels.

Studies of the origin of pulmonary blood flow heterogeneity have highlighted the significant role of vessel branching structure on flow distribution. To enable more detailed investigation of structure-function relationships in the pulmonary circulation, an anatomically based finite element model of the arterial and venous networks has been developed to more accurately reflect the geometry found in vivo. Geometric models of the arterial and venous tree structures are created using a combination of multidetector row X-ray computed tomography imaging to define around 2,500 vessels from each tree, a volume-filling branching algorithm to generate the remaining accompanying conducting vessels, and an empirically based algorithm to generate the supernumerary vessel geometry. The explicit generation of supernumerary vessels is a unique feature of the computational model. Analysis of branching properties and geometric parameters demonstrates close correlation between the model geometry and anatomical measures of human pulmonary blood vessels. A total of 12 Strahler orders for the arterial system and 10 Strahler orders for the venous system are generated, down to the equivalent level of the terminal bronchioles in the bronchial tree. A simple Poiseuille flow solution, assuming rigid vessels, is obtained within the arterial geometry of the left lung, demonstrating a large amount of heterogeneity in the flow distribution, especially with inclusion of supernumerary vessels. This model has been constructed to accurately represent available morphometric data derived from the complex asymmetric branching structure of the human pulmonary vasculature in a form that will be suitable for application in functional simulations.     

Flow-induced vasodilation in the ferret lung

Chammas, Joseph H., David. A. Rickaby, Margarita Guarin,John H. Linehan, Christopher C. Hanger, and Christopher A. Dawson. Flow-induced vasodilation in the ferret lung. J. Appl. Physiol. 83(2): 495-502, 1997.To examinethe possibility that shear stress may be a pulmonary vasodilatorstimulus, we studied the effect of changing blood flow on the diametersof small pulmonary arteries in isolated perfused ferret lung lobes. Thearteries studied were in the ~0.3- to 1.3-mm-diameter range, and thediameters were measured by using microfocal X-ray imaging. Thediameters were measured at two flow rates, 10 and 40 ml/min, with theintravascular pressure in the measured vessels the same at the two flowrates as the result of venous pressure adjustment. The response to a change in flow was studied under both normoxic and hypoxic conditions. Hypoxia was used to elevate pulmonary arterial tone to increase thelikelihood of detecting a vasodilator response. Under normoxic conditions, changing flow had little effect on the arterial diameters, but under hypoxic conditions the arteries were consistently larger atthe higher flow than at the lower flow, even though the distending pressure was the same at the two flow rates. The results are consistent with the hypothesis that shear stress is a pulmonary vasodilator stimulus.

     

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.

     

Distribution of blood flow and neutrophil kinetics in bronchial vasculature of sheep

Baile, Elisabeth M., Peter D. Paré, David Ernest, andPeter M. Dodek. Distribution of blood flow and neutrophil kinetics in bronchial vasculature of sheep. J. Appl.Physiol. 82(5): 1466-1471, 1997.The bronchialcirculation, as opposed to the pulmonary circulation, is the likelysource of the edema and inflammatory cells that contribute to airflowobstruction and airway narrowing associated with asthma and pulmonaryedema. The purpose of this study was to understand the mechanism ofedema formation and inflammation in airway walls. Therefore, we soughtfirst to determine the normal bronchial venous drainage pathways. Inanesthetized, ventilated, open-chest sheep we measured the relativedistribution of ⁵¹Cr-labeled redblood cells to the right and left ventricles after injection into thebronchial artery (n = 7).Using this information, we then studied the kinetics of leukocytes inthe bronchial vascular bed. We measured the extraction of¹¹¹In-labeled neutrophils duringtheir first pass through the microvasculature after injection into thebronchial artery or right ventricle (n = 6). In the first set of experiments, we found >85% of the systemic blood flow to the lung returns to the left ventricle. In the second setof experiments, we found that extraction of neutrophils in thebronchial vasculature (50-60%) was less(P < 0.05) than that in thepulmonary vasculature (80%). This finding may be explained bydifferences in the anatomy and/or hydrodynamic dispersal forces between the pulmonary and bronchial vascular beds or may reflect sequestration of neutrophils within the pulmonary microvasculature while traversing bronchial-to-pulmonary anastomotic pathways.

     

Nitric oxide and endothelial permeability

Hinder, Frank, Michael Booke, Lillian D. Traber, and DanielL. Traber. Nitric oxide and endothelial permeability.J. Appl. Physiol. 83(6):1941-1946, 1997.Nitric oxide synthase inhibition reversessystemic vasodilation during sepsis but may increase endothelialpermeability. To assess adverse effects on the pulmonary vasculature,12 sheep were chronically instrumented with lung lymph fistulas andhydraulic pulmonary venous occluders. Escherichia coli endotoxin (lipopolysaccharide; 10 ng · kg¹ · min¹)was continuously infused for 32 h. After 24 h, six animals received 25 mg/kg of N-nitro-L-argininemethyl ester (L-NAME), and sixreceived saline. All sheep developed a hyperdynamic circulatoryresponse and elevated lymph flows by 24 h of lipopolysaccharideinfusion. L-NAME reversed systemic vasodilation, increased pre- and postcapillary pulmonary vascular resistance index, pulmonary arterial pressure, and,transiently, effective pulmonary capillary pressure. Lung lymph flowswere not different between groups at 24 h or thereafter. Calculated aschanges from baseline, however, lung lymph flow was higher in theL-NAME group than in the controlanimals, with a trend toward lower lymph-to-plasma proteinconcentration ratio at 25 h. Permeability analysis at 32 h by thevenous occlusion technique showed normal reflection coefficients andelevated filtration coefficients without differences between groups.Reversal by L-NAME of thesystemic vasodilation during endotoxemia was associated with highpulmonary vascular resistance without evidence of impaired pulmonaryendothelial barrier function.

     

Pulmonary vascular pressures of exercising Thoroughbred horses with and without endoscopic evidence of EIPH

Manohar, Murli, and Thomas E. Goetz. Pulmonary vascularpressures of exercising Thoroughbred horses with and without endoscopicevidence of EIPH. J. Appl. Physiol.81(4): 1589-1593, 1996.Exercise-induced pulmonary hemorrhage(EIPH) is a common occurrence in racehorses. The objective of thisstudy was to compare pulmonary vascular pressures of healthyThoroughbred horses with and without postexertion endoscopicallydetectable fresh blood in the trachea. The nasopharynx, larynx, andtrachea (down to the carina) of horses were examined weekly with anendoscope 55-60 min postexertion, and the diagnosis of EIPH wasconfirmed by the presence of fresh blood in the trachea. Measurementsof heart rate and right atrial, pulmonary arterial, and pulmonaryarterial wedge pressures were made during quiet rest and duringtreadmill exercise performed at 14.5 m/s on a 5% uphillgrade. This workload elicited maximal heart rate of thehorses. Mean pulmonary capillary pressure was estimated to be halfwaybetween the mean pulmonary arterial pressure and the mean pulmonaryarterial wedge pressure. These data from 7 healthy soundexercise-trained horses that were positive on 12 consecutive occasions(at 1-wk intervals) for the postexercise presence of fresh blood in thetrachea were compared with those in 8 healthy horses that wereconsistently negative for the evidence of fresh blood in the trachea onpostexercise endoscopic examination over 12-16 wk. The heart rateand the right heart and/or pulmonary vascular pressures in the twogroups of horses were similar at rest. Exercise wasattended by a large significant (P < 0.05) increase in these pressures and heart rate in both groups.However, statistically significant differences between endoscopicallyEIPH-positive and endoscopically EIPH-negative horses for heart rateand right atrial and pulmonary vascular pressures were not found duringexercise. Thus these data revealed that the magnitude ofexercise-induced right atrial as well as pulmonary arterial, capillary,and venous hypertension in endoscopically EIPH-positive horses that areotherwise healthy is quite similar to that in endoscopicallyEIPH-negative horses during comparable exertion.

     

Morphometry of cat's pulmonary arterial tree

Morphometic data of the pulmonary artery in the cat's right lung are presented. Silicone elastomer casts of cat's right lung were made, and measured, counted and analyzed. The Strahler system is used to describe the branching pattern of the arterial vascular tree. These data are needed for any quantitative approach to the study of the pulmonary circulation. For all the pulmonary blood vessels of the cat lying between the main pulmonary artery and the capillary beds, there are a total of 10 orders of vessels in the right upper lobe, 9 orders of vessels in the right middle lobe and 11 orders of vessels in the right lower lobe. The ratio of the number of branches in successive orders of vessels or the branching ratio, is 3.58. The corresponding average diameter ratio is 1.72, whereas the average length ratio is 1.81.     

Reflex tracheal smooth muscle contraction and bronchial vasodilation evoked by airway cooling in dogs

Pisarri, Thomas E., and Gordon G. Giesbrecht. Reflextracheal smooth muscle contraction and bronchial vasodilation evoked byairway cooling in dogs. J. Appl.Physiol. 82(5): 1566-1572, 1997.Coolingintrathoracic airways by filling the pulmonary circulation with coldblood alters pulmonary mechanoreceptor discharge. To determine whetherthis initiates reflex changes that could contribute to airwayobstruction, we measured changes in tracheal smooth muscle tension andbronchial arterial flow evoked by cooling. In ninechloralose-anesthetized open-chest dogs, the right pulmonary artery wascannulated and perfused; the left lung, ventilated separately, providedgas exchange. With the right lung phasically ventilated, filling theright pulmonary circulation with 5°C blood increased smooth muscletension in an innervated upper tracheal segment by 23 ± 6 (SE) gfrom a baseline of 75 g. Contraction began within 10 s of injection andwas maximal at ~30s. The response was abolished by cervical vagotomy.Bronchial arterial flow increased from 8 ± 1 to 13 ± 2 ml/min, withlittle effect on arterial blood pressure. The time course wassimilar to that of the tracheal response. This response was greatlyattenuated after cervical vagotomy. Blood at 20°C also increasedtracheal smooth muscle tension and bronchial flow, whereas 37°Cblood had little effect. The results suggest that alteration ofairway mechanoreceptor discharge by cooling can initiate reflexes thatcontribute to airway obstruction.

     

Endothelin blockade augments pulmonary vasodilation in the ovine fetus

Ivy, D. Dunbar, John P. Kinsella, and Steven H. Abman.Endothelin blockade augments pulmonary vasodilation in the ovine fetus. J. Appl. Physiol. 81(6):2481-2487, 1996.The physiological role of endothelin-1 (ET-1) inregulation of vascular tone in the perinatal lung is controversial.Recent studies suggest that ET-1 contributes to high basal pulmonaryvascular resistance in the normal fetus, but its role in the modulationof pulmonary vascular tone remains uncertain. We hypothesized that highET-1 activity opposes the vasodilator response to some physiological stimuli such as increased pressure. To test the hypothesis that ET-1modulates fetal pulmonary vascular responses to acute and prolongedphysiological stimuli, we performed a series of experiments in thelate-gestation ovine fetus. We studied the hemodynamic effects of twoET-1 antagonists, BQ-123 (a selectiveET_A-receptor antagonist) andphosphoramidon (a nonselective ET-1-converting enzyme inhibitor) duringmechanical increases in pressure due to partial ductus arteriosuscompression in chronically prepared late-gestation fetal lambs. Incontrol studies, partial ductus arteriosus compression decreased theratio of pulmonary arterial pressure to pulmonary artery flow in theleft lung 34 ± 6% from baseline. Intrapulmonary infusions ofBQ-123 (0.5 µg/min for 10 min; 0.025 µg/min for 2 h) orphosphoramidon (1.0 mg/min for 10 min) augmented the peak vasodilatorresponse during ductus arteriosus compression (52 ± 3 and 49 ± 6% from baseline, respectively, P < 0.05 vs. control). In addition, unlike the transient vasodilator response to ductus arteriosus compression in control studies, ET-1blockade with BQ-123 or phosphoramidon prolonged the increase in flowcaused by ductus arteriosus compression. In summary,ET_A-receptor blockade andET-1-converting enzyme inhibition augment and prolong fetal pulmonaryvasodilation during partial compression of the ductus arteriosus. Weconclude that ET-1 activity modulates acute and prolonged responses ofthe fetal pulmonary circulation to changes in vascular pressure. Wespeculate that ET-1 contributes to regulation and maintenance of highpulmonary vascular resistance in the normal ovine fetal lung.

     

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).

     

A new approach to blood flow simulation in vascular networks

A proper analysis of blood flow is contingent upon accurate modelling of the branching pattern and vascular geometry of the network of interest. It is challenging to reconstruct the entire vascular network of any organ experimentally, in particular the pulmonary vasculature, because of its very high number of vessels, complexity of the branching pattern and poor accessibility in vivo. The objective of our research is to develop an innovative approach for the reconstruction of the full pulmonary vascular tree from available morphometric data. Our method consists of the use of morphometric data on those parts of the pulmonary vascular tree that are too small to reconstruct by medical imaging methods. This method is a three-step technique that reconstructs the entire pulmonary arterial tree down to the capillary bed. Vessels greater than 2 mm are reconstructed from direct volume and surface analysis using contrast-enhanced computed tomography. Vessels smaller than 2 mm are reconstructed from available morphometric and distensibility data and rearranged by applying Murray's laws. Implementation of morphometric data to reconstruct the branching pattern and applying Murray's laws to every vessel bifurcation simultaneously leads to an accurate vascular tree reconstruction. The reconstruction algorithm generates full arterial tree topography down to the ?rst capillary bifurcation. Geometry of each order of the vascular tree is generated separately to minimize the construction and simulation time. The node-to-node connectivity along with the diameter and length of every vessel segment is established and order numbers, according to the diameter-de?ned Strahler system, are assigned. In conclusion, the present model provides a morphological foundation for future analysis of blood flow in the pulmonary circulation     

Bronchial vascular contribution to lung lymph flow

The lymphatic vessels of thelung provide an important route for clearance of interstitial edemafluid filtered from pulmonary blood vessels. However, the importance oflung lymphatics for the removal of airway liquid filtered from thesystemic circulation of the lung has not been demonstrated. We studiedthe contribution of the bronchial vasculature to lung lymph flow inanesthetized, ventilated sheep (n = 35). With the bronchial artery cannulated and perfused (control flow = 0.6 ml · min¹ · kg¹),lymph flow from the efferent duct of the caudal mediastinal lymph nodewas measured 1) during increasedbronchial vascular perfusion (300% of control flow);2) with a hydrated interstitium induced by a 1-h period of left atrial hypertension and subsequent recovery, both with and without bronchial perfusion; and3) during infusion (directly intothe bronchial artery) of bradykinin, an inflammatory mediator known tocause changes in bronchial vascular permeability. Increased bronchialperfusion for 90 min resulted in an average 35% increase in lung lymphflow. During left atrial hypertension, the increase in lung lymph flowwas significantly greater with bronchial perfusion (339% increase overbaseline) than without bronchial perfusion (138% increase).Furthermore, recovery after left atrial hypertension was more completeafter 90 min without bronchial perfusion (91%) than with bronchialperfusion (63%). Infusion of bradykinin into the bronchial arteryresulted in a prompt and prolonged 107% increase in lung lymph flow.This was not seen if the same dose was infused into the pulmonaryartery. Thus bronchial vascular transudate contributes significantly to lymph flow from the efferent duct of the caudal mediastinal lymph node.These results demonstrate that lymph vessels clear excess fluid fromthe airway wall and should be considered when evaluating the effect ofvascular leak in airway obstruction.

     

Thromboxane A2 mediates increased pulmonary microvascular permeability after intestinal reperfusion

Turnage, Richard H., John L. LaNoue, Kevin M. Kadesky, YanMeng, and Stuart I. Myers. ThromboxaneA₂ mediates increased pulmonarymicrovascular permeability after intestinal reperfusion. J. Appl. Physiol. 82(2): 592-598, 1997.This study examines the hypothesis that intestinal reperfusion(IR)-induced pulmonary thromboxane A₂(TxA₂) release increases localmicrovascular permeability and induces pulmonary vasoconstriction.Sprague-Dawley rats underwent 120 min of intestinal ischemia and 60 minof IR. Sham-operated animals (Sham) served as controls. After IR orSham, the pulmonary vessels were cannulated, and the lungs wereperfused in vitro with Krebs buffer. Microvascular permeability wasquantitated by determining the filtration coefficient(K_f),and pulmonary arterial (Ppa), venous (Ppv), and capillary (Ppc)pressures were measured to calculate vascular resistance (Rt). Afterbaseline measurements, imidazole(TxA₂ synthase inhibitor) orSQ-29,548 (TxA₂-receptorantagonist) was added to the perfusate; thenK_f, Ppa, Ppv, and Ppc were again measured. TheK_fof lungs from IR animals was four times greater than that of Sham(P = 0.001), and Rt was 63% greaterin the injured group (P = 0.01). Pc of IR lungs was twice that of controls (5.4 ± 1.0 vs. 2.83 ± 0.3 mmHg, IR vs. Sham, respectively; P < 0.05). Imidazole or SQ-29,548 returnedK_fto baseline measurements (P < 0.05)and reduced Rt by 23 and 17%, respectively(P < 0.05). IR-induced increases in Pc were only slightly reduced by 500 µg/ml imidazole (14%;P = 0.05) but unaffected by lowerdoses of imidazole (5 or 50 µg/ml) or SQ-29,548. These data suggestthat IR-induced pulmonary edema is caused by both increasedmicrovascular permeability and increased hydrostatic pressure and thatthese changes are due, at least in part, to the ongoing release ofTxA₂.

     

Reflex responses to regional venous pooling during lower body negative pressure in humans

Halliwill, John R., Lori A. Lawler, Tamara J. Eickhoff,Michael J. Joyner, and Sharon L. Mulvagh. Reflex responses toregional venous pooling during lower body negative pressure in humans.J. Appl. Physiol. 84(2): 454-458, 1998.Lower body negative pressure is frequently used to simulateorthostasis. Prior data suggest that venous pooling in abdominal orpelvic regions may have major hemodynamic consequences. Therefore, we developed a simple paradigm for assessing regional contributions tovenous pooling during lower body negative pressure. Sixteen healthy menand women underwent graded lower body negative pressure protocols to 60 mmHg while wearing medical antishock trousers to prevent venous poolingunder three randomized conditions:1) no trouser inflation (control),2) only the trouser legs inflated, and 3) the trouser legs andabdominopelvic region inflated. Without trouser inflation, heart rateincreased 28 ± 4 beats/min, mean arterial pressure fell 3 ± 2 mmHg, and forearm vascular resistance increased 51 ± 9 units at 60 mmHg lower body negative pressure. With inflation of eitherthe trouser legs or the trouser legs and abdominopelvic region, heartrate and mean arterial pressure did not change during lower bodynegative pressure. By contrast, although the forearm vasoconstrictorresponse to lower body negative pressure was attenuated by inflation ofthe trouser legs (forearm vascular resistance 33 ± 10 units,P < 0.05 vs. control), attenuation was greater with the inflation of the trouser legs and abdominopelvic region (forearm vascular resistance 16 ± 5 units,P < 0.05 vs. control and trouserlegs-only inflation). Thus the hemodynamic consequences of pooling inthe abdominal and pelvic regions during lower body negative pressureappear to be less than in the legs in healthy individuals.

     

Nature and site of action of endogenous nitric oxide in vasculature of isolated pig lungs

Cremona, George, Tim Higenbottam, Motoshi Takao, Edward A. Bower, and Leslie W. Hall. Nature and site of action of endogenousnitric oxide in vasculature of isolated pig lungs. J. Appl. Physiol. 82(1): 23-31, 1997.The site ofaction of endogenous and exogenous nitric oxide (NO) in isolated piglungs was investigated by using arterial, double, and venous occlusion,which allowed precapillary, postcapillary, and venous segments to bepartitioned into arterial, precapillary, postcapillary, and venoussegments. N^G-nitro-L-arginine(L-NNA;10⁵ M) increased resistancein the arterial (35 ± 6.6%, P = 0.003), precapillary (39.3 ± 5.1%,P = 0.001), and venous (18.3 ± 4.8%, P = 0.01) segments,respectively. Sodium nitroprusside(10⁵ M) and NO (80 parts/million) reversed the effects ofL-NNA. Total pulmonary vascularresistance fell with increasing flow, due to a fall in precapillaryresistance and dynamic resistance, and was significantlylower than mean total resistance.L-NNA increased the resistancesbut did not alter the pattern of the pressure-flow relationships. It isconcluded that, in isolated pig lungs, the effect of endogenous NOseems to be dependent on flow in the arterial segment and independentof flow in the precapillary segment, but variation of its release doesnot appear to be fundamental to accommodation to changes in steadyflow.

     

Intratracheal instillation of a novel NO/nucleophile adduct selectively reduces pulmonary hypertension

Brilli, Richard J., Brian Krafte-Jacobs, Daniel J. Smith,Dominick Roselle, Daniel Passerini, Amos Vromen, Lori Moore, CsabaSzabó, and Andrew L. Salzman. Intratracheal instillation ofa novel NO/nucleophile adduct selectively reduces pulmonary hypertension. J. Appl. Physiol. 83(6):1968-1975, 1997.We examined the pulmonary and systemichemodynamic effects of administering soluble nitric oxide (NO) donorcompounds (NO/nucleophile adducts, i.e., NONOates) directly into thetrachea of animals with experimentally induced pulmonary hypertension.Steady-state pulmonary hypertension was created by using thethromboxane agonist U-46619. Yorkshire pigs were randomly assigned toone of four groups: group 1,intratracheal saline (control; n = 8);group 2, intratracheal sodiumnitroprusside (n = 6);group 3, intratracheal ethylputreanineNONOate (n = 6); andgroup 4, intratracheal2-(dimethylamino)-ethylputreanine NONOate (DMAEP/NO;n = 6). Pulmonary and systemichemodynamics were monitored after drug instillation.Group 4 had significant reductions in pulmonary vascular resistance index (PVRI) at all time points comparedwith steady state and compared with group1 (P < 0.05), whereas systemic vascular resistance index did not change. The meanchange in mean pulmonary arterial pressure in group4 was 33.1 ± 1.2% compared with +6.4 ± 1.3% in group 1 (P < 0.001), and the mean change inmean arterial pressure was 9.3 ± 0.7% compared with acontrol value of 0.9 ± 0.5%(P < 0.05). Groups 2 and 3 hadsignificant decreases in both PVRI and systemic vascular resistanceindex compared with steady state and with group1. In conclusion, intratracheal instillation of apolar-charged tertiary amine NONOate DMAEP/NO results in the selectivereduction of PVRI. Intermittent intratracheal instillation of selectiveNONOates may be an alternative to continuously inhaled NO in thetreatment of pulmonary hypertension.

     

Effects of hypoxic pulmonary vasoconstriction on pulmonary gas exchange

Brimioulle, Serge, Philippe Lejeune, and Robert Naeije.Effects of hypoxic pulmonary vasoconstriction on pulmonary gasexchange. J. Appl. Physiol. 81(4):1535-1543, 1996.Several reports have suggested that hypoxicpulmonary vasoconstriction (HPV) might result in deterioration ofpulmonary gas exchange in severe hypoxia. We therefore investigated theeffects of HPV on gas exchange in normal and diseased lungs. Weincorporated a biphasic HPV stimulus-response curve observed in intactdogs (S. Brimioulle, P. Lejeune, J. L. Vachièry, M. Delcroix, R. Hallemans, and R. Naeije, J. Appl.Physiol. 77: 476-480, 1994) into a 50-compartment lung model (J. B. West, Respir.Physiol. 7: 88-110, 1969) to control the amount ofblood flow directed to each lung compartment according to the localhypoxic stimulus. The resulting model accurately reproduced the bloodgas modifications caused by HPV changes in dogs with acute lung injury.In single lung units, HPV had a moderate protective effect on alveolaroxygenation, which was maximal at near-normal alveolarPO₂ (75-80 Torr), mixed venousPO₂ (35 Torr), andPO₂ at which hemoglobin is 50%saturated (24 Torr). In simulated diseased lungs associated with40-60 Torr arterial PO₂,however, HPV increased arterial PO₂ by 15-20 Torr. We conclude that HPV can improve arterialoxygenation substantially in respiratory failure.

     

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.

     

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.