Effects of Slow Deep Breathing at High Altitude on Oxygen Saturation,Pulmonary and Systemic Hemodynamics

Slow deep breathing improves blood oxygenation (Sp_O2) and affects hemodynamics in hypoxic patients. We investigated the ventilatory and hemodynamic effects of slow deep breathing in normal subjects at high altitude. We collected data in healthy lowlanders staying either at 4559 m for 2–3 days (Study A; N = 39) or at 5400 m for 12–16 days (Study B; N = 28). Study variables, including Sp_O2 and systemic and pulmonary arterial pressure, were assessed before, during and after 15 minutes of breathing at 6 breaths/min. At the end of slow breathing, an increase in Sp_O2 (Study A: from 80.2±7.7% to 89.5±8.2%; Study B: from 81.0±4.2% to 88.6±4.5; both p<0.001) and significant reductions in systemic and pulmonary arterial pressure occurred. This was associated with increased tidal volume and no changes in minute ventilation or pulmonary CO diffusion. Slow deep breathing improves ventilation efficiency for oxygen as shown by blood oxygenation increase, and it reduces systemic and pulmonary blood pressure at high altitude but does not change pulmonary gas diffusion.     

Positive Expiratory Pressure Improves Oxygenation in Healthy Subjects Exposed to Hypoxia

Introduction

Positive end-expiratory pressure (PEEP) is commonly used in critical care medicine to improve gas exchange. Altitude sickness is associated with exaggerated reduction in arterial oxygenation. We assessed the effect of PEEP and pursed lips breathing (PLB) on arterial and tissue oxygenation under normobaric and hypobaric hypoxic conditions.

Methods

Sixteen healthy volunteers were exposed to acute normobaric hypoxia (Laboratory study, FiO₂=0.12). The protocol consisted in 3-min phases with PEEPs of 0, 5 or 10 cmH₂O, PLB or similar ventilation than with PEEP-10, interspaced with 3-min phases of free breathing. Arterial (pulse oximetry) and quadriceps (near-infrared spectroscopy) oxygenation, ventilation, cardiac function, esophageal and gastric pressures and subjects’ subjective perceptions were recorded continuously. In addition, the effect of PEEP on arterial oxygenation was tested at 4,350 m of altitude in 9 volunteers breathing for 20 min with PEEP-10 (Field study).

Results

During the laboratory study, PEEP-10 increased arterial and quadriceps oxygenation (arterial oxygen saturation +5.6±5.0% and quadriceps oxyhemoglobin +58±73 µmol.cm compared to free breathing; p<0.05). Conversely, PLB did not increase oxygenation. Oxygenation improvement with PEEP-10 was accompanied by an increase in expiratory esophageal and gastric pressures (esophageal pressure swing +5.4±3.2 cmH₂O, p<0.05) but no change in minute ventilation, breathing pattern, end-tidal CO₂ or cardiac function (all p>0.05) compared to PEEP-0. During the field study, PEEP-10 increased arterial oxygen saturation by +6.7±6.0% after the 3^rd minute with PEEP-10 without further significant increase until the 20^th minute with PEEP-10. Subjects did not report any significant discomfort with PEEP.

Conclusions

These data indicate that 10-cmH₂O PEEP significantly improves arterial and muscle oxygenation under both normobaric and hypobaric hypoxic conditions in healthy subjects. PEEP-10 could be an attractive non-pharmacological tool to limit blood oxygen desaturation and possibly symptoms at altitude.     

Effect of Nitrazepam in Chronic Obstructive Bronchitis

The effect of nitrazepam on ventilatory capacity and arterial blood gas tensions was studied in a double-blind controlled crossover trial in six patients with chronic obstructive bronchitis in ventilatory failure (raised Paco₂). Nitrazepam produced a fall in ventilatory capacity and worsening of the ventilatory failure. In the sixth patient, while on the active drug, the Pao₂ fell from 48 to 35 mm Hg while the Paco₂ tension rose from 59·5 to 68 mm Hg. It is suggested that nitrazepam is contraindicated in patients with severe chronic obstructive bronchitis.     

Effect of acute hypoxia on respiratory muscle fatigue in healthy humans

Background

Greater diaphragm fatigue has been reported after hypoxic versus normoxic exercise, but whether this is due to increased ventilation and therefore work of breathing or reduced blood oxygenation per se remains unclear. Hence, we assessed the effect of different blood oxygenation level on isolated hyperpnoea-induced inspiratory and expiratory muscle fatigue.

Methods

Twelve healthy males performed three 15-min isocapnic hyperpnoea tests (85% of maximum voluntary ventilation with controlled breathing pattern) in normoxic, hypoxic (SpO₂ = 80%) and hyperoxic (FiO₂ = 0.60) conditions, in a random order. Before, immediately after and 30 min after hyperpnoea, transdiaphragmatic pressure (P_di,tw ) was measured during cervical magnetic stimulation to assess diaphragm contractility, and gastric pressure (P_ga,tw ) was measured during thoracic magnetic stimulation to assess abdominal muscle contractility. Two-way analysis of variance (time x condition) was used to compare hyperpnoea-induced respiratory muscle fatigue between conditions.

Results

Hypoxia enhanced hyperpnoea-induced P_di,tw and P_ga,tw reductions both immediately after hyperpnoea (P_di,tw : normoxia -22 ± 7% vs hypoxia -34 ± 8% vs hyperoxia -21 ± 8%; P_ga,tw : normoxia -17 ± 7% vs hypoxia -26 ± 10% vs hyperoxia -16 ± 11%; all P < 0.05) and after 30 min of recovery (P_di,tw : normoxia -10 ± 7% vs hypoxia -16 ± 8% vs hyperoxia -8 ± 7%; P_ga,tw : normoxia -13 ± 6% vs hypoxia -21 ± 9% vs hyperoxia -12 ± 12%; all P < 0.05). No significant difference in P_di,tw or P_ga,tw reductions was observed between normoxic and hyperoxic conditions. Also, heart rate and blood lactate concentration during hyperpnoea were higher in hypoxia compared to normoxia and hyperoxia.

Conclusions

These results demonstrate that hypoxia exacerbates both diaphragm and abdominal muscle fatigability. These results emphasize the potential role of respiratory muscle fatigue in exercise performance limitation under conditions coupling increased work of breathing and reduced O₂ transport as during exercise in altitude or in hypoxemic patients.     

Comparison of Effect of Two Induction Doses of Methohexitone on Infants Delivered by Elective Caesarean Section

Observations were made on 26 infants delivered by elective caesarean section under general anaesthesia. A standard anaesthetic technique was employed using a methohexitone, relaxant, nitrous oxide-oxygen sequence with regulated ventilation and the administration of papaveretum after clamping the umbilical cord. In 12 patients the induction dose of methohexitone was 1·4mg/kg and in 14 it was reduced to 1·0 mg/kg. There were no significant differences between the two groups in the clinical status of the mothers, in operative technique and timing, or in the value of PO₂, PCO₂, and pH in the umbilical cord venous blood.The infants whose mothers received the lower dose of methohexitone were in better condition, as assessed by the number needing assisted ventilation, the time taken to establish regular respiration, the Apgar score, and the “Apgar minus colour” score.     

Long-term antihypertensive treatment inhibiting progression of diabetic nephropathy

Six men aged 26-35 years with proteinuria due to insulindependent juvenile-onset diabetes were treated for moderate hypertension (mean blood pressure 162/103 mm Hg) and studied for a mean of 73 months for the effect on the progression of nephropathy. All patients were of normal weight. During a mean control period of 28 months before treatment the mean glomerular filtration rate (three or four measurements) was 86·1 ml/min and mean 24-hour urinary albumin excretion (also three or four measurements) 3·9 g (range 0·5-8·8 g).During antihypertensive treatment the mean systolic blood pressure fell to 144 mm Hg and mean diastolic pressure to 95 mm Hg. In the control period five patients had shown a mean monthly decline in glomerular filtration rate of 1·23 ml/min; with antihypertensive treatment, however, this decline fell to 0·49 ml/min (2p=0·042). In the remaining patient the glomerular filtration rate was 137 ml/min before treatment and 135 ml/min at the end of the treatment period. In all patients the mean yearly increase in albumin clearance (expressed as a percentage of the glomerular filtration rate) fell from 107% before treatment to 5% during treatment (2p=0·0099).This small study indicates that antihypertensive treatment slows the decline in renal function in diabetic nephropathy. Clinical trials beginning treatment in the incipient phase of diabetic nephropathy will define the optimal modality of treatment in this large patient population.     

Exposure to a combination of heat and hyperoxia during cycling at submaximal intensity does not alter thermoregulatory responses

In this study, we tested the hypothesis that breathing hyperoxic air (F_inO₂ = 0.40) while exercising in a hot environment exerts negative effects on the total tissue level of haemoglobin concentration (tHb); core (T_core) and skin (T_skin) temperatures; muscle activity; heart rate; blood concentration of lactate; pH; partial pressure of oxygen (P_aO₂) and carbon dioxide; arterial oxygen saturation (S_aO₂); and perceptual responses. Ten well-trained male athletes cycled at submaximal intensity at 21°C or 33°C in randomized order: first for 20 min while breathing normal air (F_inO₂ = 0.21) and then 10 min with F_inO₂ = 0.40 (HOX). At both temperatures, S_aO₂ and P_aO₂, but not tHb, were increased by HOX. Tskin and perception of exertion and thermal discomfort were higher at 33°C than 21°C (p < 0.01), but independent of F_inO₂. T_core and muscle activity were the same under all conditions (p > 0.07). Blood lactate and heart rate were higher at 33°C than 21°C. In conclusion, during 30 min of submaximal cycling at 21°C or 33°C, T_core, T_skin and T_body, tHb, muscle activity and ratings of perceived exertion and thermal discomfort were the same under normoxic and hyperoxic conditions. Accordingly, breathing hyperoxic air (F_inO₂ = 0.40) did not affect thermoregulation under these conditions.     

Postural influence on maternal capillary oxygen and carbon dioxide tension

The effect of posture on maternal capillary blood Po₂ and Pco₂ was studied in pregnant and non-pregnant women. There was a significant decrease of Po₂ (mean 13·0 mm. Hg) and significant decrease of Pco₂ (mean 2·4 mm. Hg) when pregnant women sat up, but these changes did not occur in the non-pregnant. These findings may be relevant to debate on the optimum posture for labour.     

Negative Pressure Artificial Respiration: Use in Treatment of Respiratory Failure of the Newborn

Ninety-one infants with respiratory failure secondary to primary pulmonary disease and with a birth weight of 1000 g. or over have been managed in a negative-pressure respirator (Air-Shields) over a three-year period. Of these the failure in 87 was due to respiratory distress syndrome (RDS) and in four it resulted from massive meconium aspiration. Respiratory failure was indicated initially by arterial blood gas tensions (while breathing 100% O₂) of Po₂ <40 mm. Hg, pH <7.10 and Pco₂ >75 mm. Hg in the initial 47 cases; these levels were subsequently raised to Po₂ < 50 mm. Hg, pH <7.20 and Pco₂ >70 mm. Hg for the remainder. Fifty-four (59.3%) of the infants survived the use of the respirator and 47 of these (51.6%) were subsequently discharged alive and well. Mean time in hours to normalization of blood gas values while on the respirator were as follows: for Po₂, 10.5; for pH, 11.6; and for Pco₂, 22.6. These values indicate that the respirator is more efficient in promoting oxygenation (raising Po₂) than ventilation (lowering Pco₂). They also suggest that the observed acidosis is in large part secondary to the hypoxia rather than the result of co₂ retention. For the survivors the average time of total respirator dependency before commencement of weaning was 53.7 hours. All the infants were managed without the use of endotracheal tubes although the use of the respirator and/or administration of 100% oxygen were either continuous or intermittent for periods of up to two weeks. There have been no instances of so-called respirator lung disease in the survivors or in those who died, which suggests that the use of high oxygen concentration by itself is not the major factor in the pathogenesis of this complication.     

Impaired renal functional reserve and albuminuria in essential hypertension

The stimulatory effects of an infusion of amino acids on glomerular filtration rate has previously been used to measure renal functional reserve and detect glomerular hyperfiltration. Thirty four patients with mild to moderate essential hypertension and seemingly normal renal function and 22 healthy controls were given infusions of amino acids to investigate whether renal functional reserve is reduced in essential hypertension and to detect patients at risk of renal damage. Although basal creatinine clearance increased after the infusion of amino acids in the controls (mean 27·9 ml/min; 95% confidence interval 18·2 to 37·6), the overall change was lower in the patients (mean 13·4 ml/min; 8·3 to 18·5), 11 of the 34 showing no increase at all. In these 11 non-responders the mean systolic blood pressure was higher than that in the 23 others (178·5 mm Hg v 157 mm Hg, respectively). Mean urinary albumin excretion was abnormal in the patients (93·3 mg/24 h; 44·2 to 142·4); eight of the 11 non-responders had an albumin excretion above the normal range (>20 mg/24 h). In the 11 patients without renal functional reserve a positive correlation was found between basal creatinine clearance and albumin excretion (r=0·695).As consumed renal reserve and albuminuria are markers of glomerular hyperfiltration studying renal function before and after infusion of amino acids can detect hypertensive patients at risk of progressive renal damage.     

Acute Pancreatitis and Diabetic Ketoacidosis in Accidental Hypothermia and Hypothermic Myxoedema

Serial serum amylase and blood glucose levels were measured in 68 hypothermic (rectal temperature 35°C or less) patients, including 15 who had hypothermic myxoedema (serum protein bound iodine 3·5 μg/100 ml or less). Raised amylase levels were found in 34 patients and probably reflected a mild acute pancreatitis. The high amylase levels correlated with low arterial PO₂ levels and significantly with high arterial PCO₂ levels and the base deficit but not with the severity or duration of the hypothermia. The acute pancreatitis does not explain why hypothermic patients with myxoedema have a poorer prognosis than those who are euthyroid. The pancreatitis occasionally contributed to the development, sometimes delayed, of diabetic ketoacidosis, blood glucose levels of over 120 mg/100 ml being found in 20 patients. There was a significant correlation between the raised serum amylase levels and the hyperglycaemia. Hypoglycaemia, sometimes profound, was found in 12 patients.     

Arterial Blood Gas Tensions and pH in Acute Asthma in Childhood

Studies of the arterial blood gas tensions and pH in 21 children during 24 acute attacks of asthma showed that all were hypoxic on admission to hospital, and in 10 there was evidence of carbon dioxide retention. Cyanosis, invariably present when the So₂ was below 85%, and restlessness in patients breathing air were the most reliable indices of the severity of hypoxia. There were no reliable clinical guides to the Pco₂ level. Conventional oxygen therapy in tents (25–40%) did not always relieve hypoxia, and in three cases the administration of oxygen at a concentration of 40% or over failed to produce a normal arterial oxygen tension. Uncontrolled oxygen therapy may aggravate respiratory acidosis, and three of our patients developed carbon dioxide narcosis while breathing oxygen. The necessity for blood gas measurements in the management of severe acute asthma in childhood is emphasized.     

THE COMPETITIVE DEMANDS OF ELITE MALE RINK HOCKEY

The aim of this study was to simulate the activity pattern of rink hockey by designing a specific skate test (ST) to study the energy expenditure and metabolic responses to this intermittent high-intensity exercise and extrapolate the results from the test to competition. Six rink hockey players performed, in three phases, the 20-metre multi-stage shuttle roller skate test, a tournament match and the ST. Heart rate was monitored in all three phases. Blood lactate, oxygen consumption, ventilation and respiratory exchange ratio were also recorded during the ST. Peak HR was 190.7±7.2 beats · min⁻¹. There were no differences in peak HR between the three tests. Mean HR was similar between the ST and the match (86% and 87% of HR_max, respectively). Peak and mean ventilation averaged 111.0±8.8 L · min⁻¹ and 70.3±14.0 L ^· min⁻¹ (60% of V_Emax), respectively. VO_2max was 56.3±8.4 mL · kg⁻¹ · min⁻¹, and mean oxygen consumption was 40.9±7.9 mL · kg^{−1 ·} min⁻¹ (70% of VO_2max). Maximum blood lactate concentration was 7.2±1.3 mmol · L-1. ST yielded an energy expenditure of 899.1±232.9 kJ, and energy power was 59.9±15.5 kJ · min⁻¹. These findings suggest that the ST is suitable for estimating the physiological demands of competitive rink hockey, which places a heavy demand on the aerobic and anaerobic systems, and requires high energy consumption.     

Effects of Salbutamol and Isoprenaline Phenylephrine in Reversible Airways Obstruction

Ventolin (salbutamol) and Medihaler-Duo (isoprenaline/phenylephrine combination) standard pressurized inhalers were used to administer doses of two or six “puffs” to 16 patients with known reversible airways obstruction. The doses were administered in random order over two days. Both the Ventolin and Medihaler-Duo inhalers substantially increased FEV₁, but in the doses used salbutamol was more effective than isoprenaline/phenylephrine (P < 0·01). There was no significant difference between two and six puffs of salbutamol, though there seemed to be an advantage of six puffs of isoprenaline/phenylephrine over two puffs (P < 0·05). Adrenaline (1/1,000) 0·5 ml and atropine 0·6 mg produced similar increases in FEV₁ to those produced by salbutamol.The Pao₂ fell more than 5 mm Hg in three patients after salbutamol and in three after isoprenaline/phenylephrine. There was no significant fall in mean Pao₂ in any of the treatment groups. It is concluded that the Ventolin inhalant, administered in the conventional dose of two puffs, is as effective a bronchodilator as subcutaneous adrenaline and atropine, is more effective than the Medihaler-Duo, and is without detectable side effects.     

Blood Pressure in Women Taking Oral Contraceptives

A controlled prospective survey of women taking oestrogen-progestogen oral contraceptives showed increases in mean systolic and diastolic blood pressure of 14·2 mm Hg and 8·5 mm Hg respectively after four years. The largest increases in individual cases were 36 mm Hg systolic and 20 mm Hg diastolic. Blood pressure returned to pretreatment levels within three months after oral contraceptives had been stopped. These changes in blood pressure were unrelated to the progestogenic potencies of the preparations being taken.     

Retinal Vessel Oxygen Saturation during 100% Oxygen Breathing in Healthy Individuals

Purpose

To detect how systemic hyperoxia affects oxygen saturation in retinal arterioles and venules in healthy individuals.

Methods

Retinal vessel oxygen saturation was measured in 30 healthy individuals with a spectrophotometric retinal oximeter (Oxymap T1). Oximetry was performed during breathing of room air, 100% oxygen (10 minutes, 6L/min) and then again room air (10 minutes recovery).

Results

Mean oxygen saturation rises modestly in retinal arterioles during 100% oxygen breathing (94.5%±3.8 vs. 92.0%±3.7% at baseline, p<0.0001) and dramatically in retinal venules (76.2%±8.0% vs. 51.3%±5.6%, p<0.0001). The arteriovenous difference decreased during 100% oxygen breathing (18.3%±9.0% vs. 40.7%±5.7%, p<0.0001). The mean diameter of arterioles decreased during 100% oxygen breathing compared to baseline (9.7±1.4 pixels vs. 10.3±1.3 pixels, p<0.0001) and the same applies to the mean venular diameter (11.4±1.2 pixels vs. 13.3±1.5 pixels, p<0.0001).

Conclusions

Breathing 100% oxygen increases oxygen saturation in retinal arterioles and more so in venules and constricts them compared to baseline levels. The dramatic increase in oxygen saturation in venules reflects oxygen flow from the choroid and the unusual vascular anatomy and oxygen physiology of the eye.     

Is dialysis hypotension caused by an abnormality of venous tone?

The role of peripheral vascular tone in the development of hypotension induced by dialysis was investigated in eight patients undergoing haemodialysis with acetate or bicarbonate buffered fluid. Each patient had two sessions of dialysis with acetate fluid and two with bicarbonate fluid in the order acetate, bicarbonate, bicarbonate, acetate or bicarbonate, acetate, acetate, bicarbonate. Mean arterial blood pressure fell at a mean rate of 3·9 mm Hg/hour during dialysis with acetate fluid and 1·4 mm Hg/hour during dialysis with bicarbonate fluid. The rate of fall was significantly greater during dialysis with acetate fluid compared with bicarbonate fluid. Heart rate increased by a mean rate of 2·6 beats/min/hour during dialysis with both acetate and bicarbonate fluid. Vascular resistance in the forearm increased at a rate of 3·6 units/hour during dialysis with acetate fluid and 4·5 units/hour during dialysis with bicarbonate fluid, but the venous bed of the forearm dilated. The index of venous tone rose at a mean rate of 0·23 ml/100 dl over 40 mm Hg/hour during dialysis with acetate fluid and 0·20 ml/dl over 40 mm Hg/hour during dialysis with bicarbonate fluid.Inappropriate peripheral venodilatation may be important in the development of hypotension induced by dialysis.     

Dynamic hyperinflation is associated with a poor cardiovascular response to exercise in COPD patients

Background

Pulmonary hyperinflation has the potential for significant adverse effects on cardiovascular function in COPD. The aim of this study was to investigate the relationship between dynamic hyperinflation and cardiovascular response to maximal exercise in COPD patients.

Methods

We studied 48 patients (16F; age 68 yrs ± 8; BMI 26 ± 4) with COPD. All patients performed spirometry, plethysmography, lung diffusion capacity for carbon monoxide (TLco) measurement, and symptom-limited cardiopulmonary exercise test (CPET). The end-expiratory lung volume (EELV) was evaluated during the CPET. Cardiovascular response was assessed by change during exercise in oxygen pulse (ΔO₂Pulse) and double product, i.e. the product of systolic blood pressure and heart rate (DP reserve), and by the oxygen uptake efficiency slope (OUES), i.e. the relation between oxygen uptake and ventilation.

Results

Patients with a peak exercise EELV (%TLC) ≥ 75% had a significantly lower resting FEV₁/VC, FEF₅₀/FIF₅₀ ratio and IC/TLC ratio, when compared to patients with a peak exercise EELV (%TLC) < 75%. Dynamic hyperinflation was strictly associated to a poor cardiovascular response to exercise: EELV (%TLC) showed a negative correlation with ΔO₂Pulse (r = - 0.476, p = 0.001), OUES (r = - 0.452, p = 0.001) and DP reserve (r = - 0.425, p = 0.004). Furthermore, according to the ROC curve method, ΔO₂Pulse and DP reserve cut-off points which maximized sensitivity and specificity, with respect to a EELV (% TLC) value ≥ 75% as a threshold value, were ≤ 5.5 mL/bpm (0.640 sensitivity and 0.696 specificity) and ≤ 10,000 Hg · bpm (0.720 sensitivity and 0.783 specificity), respectively.

Conclusion

The present study shows that COPD patients with dynamic hyperinflation have a poor cardiovascular response to exercise. This finding supports the view that in COPD patients, dynamic hyperinflation may affect exercise performance not only by affecting ventilation, but also cardiac function.     

Response to Rimiterol and Salbutamol Aerosols Administered by Intermittent Positive-pressure Ventilation

The bronchodilator and cardiac effects produced by aerosols of 0·5% salbutamol and 0·5% and 1% rimiterol administered for three minutes in 40% oxygen by intermittent positive-pressure ventilation (I.P.P.V.) were compared in 15 asthmatic patients. Salbutamol and both the concentrations of rimiterol were equipotent in peak bronchodilator effect, but salbutamol had a significantly longer duration of bronchodilator action. There was significantly less increase in heart rate after rimiterol than after salbutamol. Aerosols of 0·5% rimiterol, 0·5% salbutamol, and saline were administered by I.P.P.V. to 10 normal volunteers. There was no difference between the mean heart rates after 0·5% rimiterol and saline but a highly significant increase in mean heart rate was observed after 0·5% salbutamol. It was concluded that 0·5% rimiterol was an effective short-acting bronchodilator drug with little or no cardiac beta₁-adrenergic activity when administered for three minutes by I.P.P.V. in 40% oxygen.     

Improvements of the Surgical Technique on the Established Mouse Model of Orthotopic Single Lung Transplantation

Background

A wide range of knockout and transgenic murine models for the study of nonimmune and immune mechanisms in lung transplants are available nowadays, but the microsurgical techniques are difficult to learn. We describe methods to simplify techniques and facilitate learning.

Methods

Traditional procedures were implemented to perform lung transplants in 30 cases (group 1). Improved techniques which included cuff without tail, broadening of the cuff diameter for bronchus, establishment of one tunnel between three structures, innovative technology of the vascular anastomosis and placement of the chest tube post-operation were used to perform lung transplants in 30 cases (group 2).

Results

The improved techniques considerably shorten operative times (96.75±6.16 min and 85.32±6.98 min in groups 1 and 2, respectively). The survival rates in the recipient animals were 86.7% and 96.7% in groups 1 and 2, respectively. Chest X-rays and macroscopic changes of transplanted recipients showed that grafts were well inflated on postoperative day 30. There was no significant difference of the arterial oxygen tension (PaO₂) between two groups (115.9±7.11 mm Hg and 116.3±6.87 mm Hg in groups 1 and 2, respectively). Histologically, no lung injury was seen in grafts.

Conclusions

We described the modified procedures of orthotopic left lung transplants in mice, which could shorten operative time and increase survival rate.