Endotracheal Cuff Pressure and Tracheal Mucosal Blood Flow

In the larger airways, the blood circulation forms a subepithelial (mucosal) and outer (peribronchial) microvascular network. This raises the possibility that blood flow in these two networks is regulated independently. We used hypoxemia as a stimulus to induce changes in tracheal mucosal blood flow normalized for systemic arterial pressure (Qtr n) measured with an inert soluble gas technique and total bronchial blood flow (Qbr) and normalized Qbr (Qbrn) measured with an electromagnetic flow probe in anesthetized sheep. Fifteen minutes of hypoxemia [PO2 40 +/- 7 (SD) Torr] decreased mean Qtr n from 1.1 +/- 0.4 to 0.8 +/- 0.4 ml.min-1.mmHg-1.10(2) (-27%; P less than 0.05; n = 7) and increased mean Qbr n from 12.1 +/- 3.2 to 17.1 +/- 5.4 ml.min-1.mmHg-1.10(2) (+41%; P less than 0.05; n = 6). The rise in Qbr correlated with cardiac output (r = 0.68; P less than 0.05). Phentolamine pretreatment (0.1 mg/kg iv) blunted the hypoxemia-related decrease of mean Qtr n (-8%; P = NS). Tyramine (2.5 mg) applied locally to the trachea decreased mean Qtr n significantly after 30 and 45 min by 31 and 19%, respectively (P less than 0.05). 6-Hydroxydopamine (0.2 mg 4 times for 1 h locally applied) prevented the hypoxemia-induced as well as local tyramine-induced decrease in mean Qtr n (0 and 0%).(ABSTRACT TRUNCATED AT 250 WORDS)

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Evaluation of tracheal mucosal blood flow during an extended radical operation for esophageal carcinoma: Clinical and experimental studies

Surgery Today ◽

10.1007/bf01833720 ◽

1994 ◽

Vol 24 (7) ◽

pp. 585-590 ◽

Cited By ~ 3

Author(s):

Renzo Nakahara ◽

Yuji Nimura ◽

Naokazu Hayakawa ◽

Akihiro Yasui ◽

Akimichi Kume ◽

...

Keyword(s):

Blood Flow ◽

Esophageal Carcinoma ◽

Experimental Studies ◽

Mucosal Blood Flow ◽

Radical Operation ◽

Tracheal Mucosal Blood Flow

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Laser-Doppler measurement of tracheal mucosal blood flow: comparison with tracheal arterial flow

Journal of Applied Physiology ◽

10.1152/jappl.1991.70.1.274 ◽

1991 ◽

Vol 70 (1) ◽

pp. 274-281 ◽

Cited By ~ 8

Author(s):

D. R. Corfield ◽

M. E. Deffebach ◽

I. Erjefalt ◽

R. O. Salonen ◽

S. E. Webber ◽

...

Keyword(s):

Blood Flow ◽

Mucosal Blood Flow ◽

Laser Doppler ◽

Doppler Measurement ◽

Tracheal Mucosa ◽

Doppler Flowmetry ◽

Arterial Perfusion ◽

Arterial Inflow ◽

Electromagnetic Flow Probe ◽

Tracheal Mucosal Blood Flow

Blood flow in the tracheal mucosa (Qm) has been measured by laser-Doppler flowmetry in anesthetized sheep and dogs. The values have been compared with tracheal arterial inflow (Qtr) by use of an electromagnetic flow probe and with tracheal arterial perfusion pressure (Ptr) produced by mechanical perfusion. Changes in blood flow were caused by injections of methacholine, phenylephrine, and histamine into the perfusion circuit. These interventions produced a range of measurements for each animal. Correlations of Qm against Qtr were significant in two of five animals (R = 0.03–0.93); correlations of Qm against Ptr were significant in two of four animals (R = 0.56–0.96). Percent changes in Qtr were generally much larger than those of Qm, and there was considerable variability between Qm and either Qtr or Ptr. Qm reflected the same vascular changes as Ptr or Qtr in 28 interventions and showed an opposing change in 4 cases. In 11 interventions, changes measured by Ptr or Qtr were not reflected by any changes in Qm. Thus qualitative changes in tracheal perfusion measured with these methods were usually the same; quantitatively the three methods showed great differences. These differences may reflect different regulatory mechanisms in various components of the tracheal vasculature or different technical aspects of the methods used.

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Measurement of airway mucosal perfusion and water volume with an inert soluble gas

Journal of Applied Physiology ◽

10.1152/jappl.1988.65.1.264 ◽

1988 ◽

Vol 65 (1) ◽

pp. 264-271 ◽

Cited By ~ 20

Author(s):

A. Wanner ◽

J. A. Barker ◽

W. M. Long ◽

A. T. Mariassy ◽

A. D. Chediak

Keyword(s):

Blood Flow ◽

Dimethyl Ether ◽

Transient State ◽

Mucosal Blood Flow ◽

Water Volume ◽

Tracheal Mucosa ◽

Tissue Water ◽

Pharmacological Agents ◽

Tracheal Mucosal Blood Flow

The purpose of this study was to develop and validate a new in vivo technique for the measurement of tracheal mucosal blood flow (Qtr) and tissue water volume (VH2O) with an inert soluble gas. The technique was based on the notion that the uptake of dimethyl ether (VDME) from an isolated tracheal segment is governed by VH2O (transient state) and Qtr (steady state). In lightly anesthetized sheep, an endotracheal tube with two cuffs placed 14.5-16.5 cm apart was placed to create a chamber into which dimethyl ether was introduced and from which VDMME into the mucosa was determined with a sensitive pneumotachograph. Mean Qtr was 1.20 ml/min (range 0.87-1.73), and mean VH2O was 1.67 ml (range 1.27-2.26). Qtr correlated with cardiac output but not with body weight or tracheal mucosal surface area determined by He dilution. VH2O did not show a correlation with any of these parameters. The response to selected pharmacological agents suggested that the measurements of Qtr and VH2O are independent of each other and from changes in tracheal diameter. Mean Qtr was 80% of mean tracheal mucosal blood flow measured with radiolabeled microspheres. We concluded that the inert soluble gas method is capable of measuring in vivo the perfusion and a water compartment of the intact tracheal mucosa.

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Tracheal mucosal blood flow responses to autonomic agonists

Journal of Applied Physiology ◽

10.1152/jappl.1988.65.2.829 ◽

1988 ◽

Vol 65 (2) ◽

pp. 829-834 ◽

Cited By ~ 20

Author(s):

J. A. Barker ◽

A. D. Chediak ◽

H. J. Baier ◽

A. Wanner

Keyword(s):

Blood Flow ◽

Mucosal Blood Flow ◽

Receptor Activation ◽

Base Line ◽

Muscarinic Agonist ◽

Adrenergic Agonist ◽

Tracheal Mucosa ◽

Adult Sheep ◽

Tracheal Mucosal Blood Flow ◽

Dose Dependent

In lightly anesthetized adult sheep, we determined tracheal mucosal blood flow (Qtr) by measuring the steady-state uptake of dimethyl ether from a tracheal chamber created by an endotracheal tube provided with two cuffs. Qtr normalized for carotid arterial pressure [Qtr(n)] was determined before and after the exposure of the tracheal mucosa to aerosolized phenylephrine (0.25-2.0 mg), isoproterenol (0.05-0.8 mg), and methacholine (2.5-20 mg). The same doses of methacholine were also administered during the intravenous infusion of vasopressin. The measurements were repeated after intravenous pretreatment with the respective antagonists phentolamine, propranolol, and atropine. Mean +/- SE base-line Qtr(n) was 1.2 +/- 0.1 ml.min-1.mmHg-1.10(2). The autonomic antagonists had no effect on mean Qtr(n). Phenylephrine produced a dose-dependent decrease in mean Qtr(n) (-70% at the highest dose), which was blunted by phentolamine, and isoproterenol produced a dose-dependent increase in mean Qtr(n) (40% at the highest dose), which was blocked by propranolol. Methacholine failed to alter mean Qtr(n) even when Qtr was first decreased by vasopressin. We conclude that in lightly anesthetized adult sheep 1) base-line Qtr(n) is not under adrenergic or cholinergic control, 2) a locally administered alpha-adrenergic agonist decreases and beta-adrenergic agonist increases Qtr(n) via specific receptor activation, and 3) a locally administered cholinergic muscarinic agonist has no effect on Qtr(n).

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