Pressure outside the extrapulmonary airway in dogs

1978 ◽  
Vol 45 (3) ◽  
pp. 437-441 ◽  
Author(s):  
S. G. Spiro ◽  
B. H. Culver ◽  
J. Butler
Keyword(s):  
Lung Volume ◽  
Standing Position ◽  
Pleural Pressure ◽  
Positive Pressure ◽  
Anterior Surface ◽  
Lung Inflation ◽  
Airway Narrowing ◽  
Thin Fluid ◽  
Airway Pressures ◽  
Anesthetized Dogs

We have measured the static and dynamic transmural pressures of extrapulmonary airways during positive pressure lung inflation in anesthetized dogs suspended in the standing position. Thin, fluid-filled catheters measured pressures within and on the anterior surface of the airways in the mediastinum and neck. The change from mediastinal to cervical static extra-airway pressures (Pea) was not abrupt but occurred through the thoracic outlet and the root of the neck. The static Pea in the mediastinum was more positive than pleural pressure when lung volume was increased with positive pressures. During forced deflation equal pressure points (EPP) were in labor bronchi from which airway narrowing extended towards the mouth. Under these conditions, the dynamic mediastinal Pea mouthward of the EPP remained close to pleural pressures even at high volumes. This suggested that forces of restitution generated in the surrounding tissues by the narrowing of the airways did have a small effect in reducing the pressure affecting their anterior surface.

Ventilation-perfusion inequality during constant-flow ventilation

1987 ◽  
Vol 62 (3) ◽  
pp. 1255-1263 ◽  
Author(s):  
P. T. Schumacker ◽  
J. I. Sznajder ◽  
A. Nahum ◽  
L. D. Wood
Keyword(s):  
Blood Flow ◽  
Gas Exchange ◽  
Lung Volume ◽  
Intermittent Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Asymmetric Distribution ◽  
Constant Flow ◽  
Arterial Pco2 ◽  
Continuous Stream ◽  
Anesthetized Dogs

Previous work by Lehnert et al. (J. Appl. Physiol. 53:483–489, 1982) has demonstrated that adequate alveolar ventilation can be maintained during apnea in anesthetized dogs by delivering a continuous stream of inspired ventilation through cannulas aimed down the main-stem bronchi. Because an asymmetric distribution of ventilation might introduce ventilation-perfusion (VA/Q) inequality, we compared gas exchange efficiency in nine anesthetized and paralyzed dogs during constant-flow ventilation (CFV) and conventional ventilation (intermittent positive-pressure ventilation, IPPV). Gas exchange was assessed using the multiple inert gas elimination technique. During CFV at 3 l X kg-1 X min-1, lung volume, retention-excretion differences (R-E*) for low- and medium-solubility gases, and the log standard deviation of blood flow (log SD Q) increased, compared with the findings during IPPV. Reducing CFV flow rate to 1 l X kg-1 X min-1 at constant lung volume improved R-E* and log SD Q, but significant VA/Q inequality compared with that at IPPV remained and arterial PCO2 rose. Comparison of IPPV and CFV at the same mean lung volume showed a similar reversible deterioration in gas exchange efficiency during CFV. We conclude that CFV causes significant VA/Q inequality which may be due to nonuniform ventilation distribution and a redistribution of pulmonary blood flow.

Changes in regional lung impedance after intravenous histamine bolus in dogs: effects of lung volume

1995 ◽  
Vol 78 (3) ◽  
pp. 875-880 ◽  
Author(s):  
Z. Balassy ◽  
M. Mishima ◽  
J. H. Bates
Keyword(s):  
Lung Volume ◽  
Time Course ◽  
Lung Inflation ◽  
Lung Elastance ◽  
Airway Narrowing ◽  
Tracheal Pressure ◽  
Lung Resistance ◽  
Regional Lung ◽  
Before And After ◽  
Induced Changes

We measured the effect of lung volume on the time course of regional lung input impedance (ZA) after bolus intravenous administration of 2 mg of histamine in seven open-chest dogs using alveolar capsule oscillators. ZA (24–200 Hz) was obtained during apnea at constant lung volume every 2 s for 80 s at lung inflation pressures of 0.1, 0.2, 0.3, 0.5, 0.7, and 1.0 kPa. Local airway resistance (RA) and elastance of the local lung region were calculated by fitting a four-parameter model to the measured ZA. Total lung resistance and lung elastance were also calculated from tracheal pressure and flow measured during mechanical ventilation (0.3 Hz) just before and after each set of ZA measurements. We found the histamine-induced changes in both lung resistance and lung elastance to decrease with increasing lung volume. RA also showed a large negative dependency on lung volume, and the variation between different RA measurements became markedly increased as lung volume decreased. In contrast, local airway elastance was essentially unaffected by lung volume. These results support the idea that parenchymal tethering of the very distal airways impedes their narrowing during bronchoconstriction. They also indicate that reduced parenchymal tethering causes airway narrowing to become markedly more inhomogeneous.

Effect of lung inflation on diaphragmatic shortening

1988 ◽  
Vol 65 (6) ◽  
pp. 2383-2389 ◽  
Author(s):  
J. D. Road ◽  
A. M. Leevers
Keyword(s):  
Positive Pressure ◽  
Inspiratory Capacity ◽  
Mean Velocity ◽  
Maximum Increase ◽  
Transdiaphragmatic Pressure ◽  
Lung Inflation ◽  
Main Determinant ◽  
Residual Capacity ◽  
Anesthetized Dogs ◽  
The Mean

The effect of lung inflation on chest wall mechanics was studied in 11 vagotomized pentobarbital sodium-anesthetized dogs. Diaphragmatic shortening (percent change from initial length at functional residual capacity, %LFRC) and transdiaphragmatic pressure swings (delta Pdi) were compared with control values over a range of positive-pressure breathing that produced a maximum increase in lung volume to 40% of inspiratory capacity. There was no change in the electromyogram of the diaphragm or parasternal intercostals during positive-pressure breathing. delta Pdi and tidal volume (VT) fell to 52 +/- 3.3 and 42.5 +/- 5% (SE) of control. This was associated with a reduction in the initial resting length of 13 +/- 1.9 and 21 +/- 2.2%LFRC (SE) in the costal and crural diaphragms, respectively. Tidal diaphragmatic shortening, however, decreased to 66 +/- 7 and 57 +/- 7 and the mean velocity decreased to 78 +/- 10 and 63 +/- 8% (SE) of control for the costal and crural diaphragms, respectively. We conclude that the reduction in diaphragmatic shortening is the main determinant of the reduced delta Pdi and VT during lung inflation and relate this to what is currently known about diaphragmatic contractile properties.

scholarly journals Esophageal pressures in acute lung injury: do they represent artifact or useful information about transpulmonary pressure, chest wall mechanics, and lung stress?

2010 ◽  
Vol 108 (3) ◽  
pp. 515-522 ◽  
Author(s):  
Stephen H. Loring ◽  
Carl R. O'Donnell ◽  
Negin Behazin ◽  
Atul Malhotra ◽  
Todd Sarge ◽  
...  
Keyword(s):  
Acute Lung Injury ◽  
Lung Injury ◽  
Critically Ill ◽  
Chest Wall ◽  
Critically Ill Patients ◽  
Transpulmonary Pressure ◽  
Pleural Pressure ◽  
Lung Inflation ◽  
Airway Pressures ◽  
Gravitational Gradients

Acute lung injury can be worsened by inappropriate mechanical ventilation, and numerous experimental studies suggest that ventilator-induced lung injury is increased by excessive lung inflation at end inspiration or inadequate lung inflation at end expiration. Lung inflation depends not only on airway pressures from the ventilator but, also, pleural pressure within the chest wall. Although esophageal pressure (Pes) measurements are often used to estimate pleural pressures in healthy subjects and patients, they are widely mistrusted and rarely used in critical illness. To assess the credibility of Pes as an estimate of pleural pressure in critically ill patients, we compared Pes measurements in 48 patients with acute lung injury with simultaneously measured gastric and bladder pressures (Pga and Pblad). End-expiratory Pes, Pga, and Pblad were high and varied widely among patients, averaging 18.6 ± 4.7, 18.4 ± 5.6, and 19.3 ± 7.8 cmH2O, respectively (mean ± SD). End-expiratory Pes was correlated with Pga ( P = 0.0004) and Pblad ( P = 0.0104) and unrelated to chest wall compliance. Pes-Pga differences were consistent with expected gravitational pressure gradients and transdiaphragmatic pressures. Transpulmonary pressure (airway pressure − Pes) was −2.8 ± 4.9 cmH2O at end exhalation and 8.3 ± 6.2 cmH2O at end inflation, values consistent with effects of mediastinal weight, gravitational gradients in pleural pressure, and airway closure at end exhalation. Lung parenchymal stress measured directly as end-inspiratory transpulmonary pressure was much less than stress inferred from the plateau airway pressures and lung and chest wall compliances. We suggest that Pes can be used to estimate transpulmonary pressures that are consistent with known physiology and can provide meaningful information, otherwise unavailable, in critically ill patients.

Effect of inflation on microvascular pressures in lungs of young rabbits

1987 ◽  
Vol 252 (1) ◽  
pp. H80-H84 ◽  
Author(s):  
J. U. Raj ◽  
P. Chen ◽  
L. Navazo
Keyword(s):  
Vascular Resistance ◽  
Lung Volume ◽  
Total Lung Capacity ◽  
Important Variable ◽  
Longitudinal Distribution ◽  
Positive Pressure ◽  
Lung Inflation ◽  
Lung Capacity ◽  
Pulmonary Arterial ◽  
Lung Blood Flow

We have examined the effect of positive pressure inflation on the longitudinal distribution of vascular resistance and intravascular pressures in isolated blood-perfused lungs of 3- to 4-wk-old rabbits. Lungs were perfused in zone 3 at airway inflation pressures (P airway) of 6, 14, and 19 cmH2O (pleural pressure, atmospheric) corresponding to 60, 80, and 90% of total lung capacity. We measured microvascular pressures by the micropipette servo-nulling technique in 20- to 50-microns diameter subpleural arterioles and venules. Pulmonary arterial and left atrial pressures were also measured. Lung blood flow was kept constant at 145 +/- 18 ml X kg body wt-1 X min-1. We found that at P airway of 6 cmH2O, approximately 55% of the total pressure drop was in arteries, approximately 23% in microvessels, and approximately 22% in veins. With increasing P airway and lung volume, there was a significant decrease in arterial and venous resistance, but an increase in resistance in microvessels. We conclude that lung inflation significantly alters the distribution of segmental vascular resistance, and therefore lung volume is an important variable that should be considered during estimation of capillary filtration pressure.

Lung volume and pleural pressure effects on ventricular function

1981 ◽  
Vol 50 (3) ◽  
pp. 630-635 ◽  
Author(s):  
B. H. Culver ◽  
J. J. Marini ◽  
J. Butler
Keyword(s):  
Right Ventricular ◽  
Ventricular Function ◽  
Lung Volume ◽  
Positive Pressure Ventilation ◽  
Left Ventricular ◽  
Pleural Pressure ◽  
Positive Pressure ◽  
Right Ventricular Afterload ◽  
Ventricular Afterload ◽  
Continuous Positive Pressure

To investigate the changes in ventricular function that occur during continuous positive-pressure ventilation, we studied the effects of separate increases in lung volume, pleural pressure, and right ventricular afterload in 15 dogs. Isovolume increases of pleural pressure caused changes in right and left ventricular hemodynamics indistinguishable from those induced by preload reduction. Lung distension with the chest open to atmosphere caused both right and left atrial intracavitary pressures to rise as cardiac output fell, suggesting altered function of both ventricles. Raising right ventricular afterload by pulmonary artery constriction did not reproduce the hemodynamic changes observed during increases of lung volume. These data indicate that the apparent alteration of ventricular function that occurs during continuous positive-pressure ventilation is produced by the associated increase in lung volume and that a right ventricular afterload-ventricular interdependence effect is not the responsible mechanism.

scholarly journals Evaluation of a Humidified Nasal High-Flow Oxygen System, Using Oxygraphy, Capnography and Measurement of Upper Airway Pressures

2011 ◽  
Vol 39 (6) ◽  
pp. 1103-1110 ◽  
Author(s):  
J. E. Ritchie ◽  
A. B. Williams ◽  
C. Gerard ◽  
H. Hockey
Keyword(s):  
Healthy Volunteers ◽  
Airway Pressure ◽  
Gas Flow ◽  
Air Entrainment ◽  
High Flow ◽  
Positive Pressure ◽  
Mean Airway Pressure ◽  
Flow Rates ◽  
Oxygen Fraction ◽  
Airway Pressures

In this study, we evaluated the performance of a humidified nasal high-flow system (Optiflow™, Fisher and Paykel Healthcare) by measuring delivered FiO2 and airway pressures. Oxygraphy, capnography and measurement of airway pressures were performed through a hypopharyngeal catheter in healthy volunteers receiving Optiflow™ humidified nasal high flow therapy at rest and with exercise. The study was conducted in a non-clinical experimental setting. Ten healthy volunteers completed the study after giving informed written consent. Participants received a delivered oxygen fraction of 0.60 with gas flow rates of 10, 20, 30, 40 and 50 l/minute in random order. FiO2, FEO2, FECO2 and airway pressures were measured. Calculation of FiO2 from FEO2 and FECO2 was later performed. Calculated FiO2 approached 0.60 as gas flow rates increased above 30 l/minute during nose breathing at rest. High peak inspiratory flow rates with exercise were associated with increased air entrainment. Hypopharyngeal pressure increased with increasing delivered gas flow rate. At 50 l/minute the system delivered a mean airway pressure of up to 7.1 cmH2O. We believe that the high gas flow rates delivered by this system enable an accurate inspired oxygen fraction to be delivered. The positive mean airway pressure created by the high flow increases the efficacy of this system and may serve as a bridge to formal positive pressure systems.

Relationship of end-expiratory pressure, lung volume, and 99mTc-DTPA clearance

1987 ◽  
Vol 63 (4) ◽  
pp. 1586-1590 ◽  
Author(s):  
J. A. Cooper ◽  
H. van der Zee ◽  
B. R. Line ◽  
A. B. Malik
Keyword(s):  
Lung Volume ◽  
Clearance Rate ◽  
Base Line ◽  
Lung Inflation ◽  
Alveolar Epithelial ◽  
Pulmonary Clearance ◽  
Residual Capacity ◽  
Dose Response Effect ◽  
Relationship Of ◽  
Line P

We investigated the dose-response effect of positive end-expiratory pressure (PEEP) and increased lung volume on the pulmonary clearance rate of aerosolized technetium-99m-labeled diethylenetriaminepentaacetic acid (99mTc-DTPA). Clearance of lung radioactivity was expressed as percent decrease per minute. Base-line clearance was measured while anesthetized sheep (n = 20) were ventilated with 0 cmH2O end-expiratory pressure. Clearance was remeasured during ventilation at 2.5, 5, 10, 15, or 20 cmH2O PEEP. Further studies showed stepwise increases in functional residual capacity (FRC) (P less than 0.05) measured at 0, 2.5, 5, 10, 15, and 20 cmH2O PEEP. At 2.5 cmH2O PEEP, the clearance rate was not different from that at base line (P less than 0.05), although FRC was increased from base line. Clearance rate increased progressively with increasing PEEP at 5, 10, and 15 cmH2O (P less than 0.05). Between 15 and 20 cmH2O PEEP, clearance rate was again unchanged, despite an increase in FRC. The pulmonary clearance of aerosolized 99mTc-DTPA shows a sigmoidal response to increasing FRC and PEEP, having both threshold and maximal effects. This relationship is most consistent with the hypothesis that alveolar epithelial permeability is increased by lung inflation.

Respiratory muscle coordination and diaphragm length during expiratory threshold loading

1991 ◽  
Vol 70 (4) ◽  
pp. 1554-1562 ◽  
Author(s):  
J. D. Road ◽  
A. M. Leevers ◽  
E. Goldman ◽  
A. Grassino
Keyword(s):  
Lung Volume ◽  
Respiratory Muscle ◽  
Abdominal Muscles ◽  
Muscle Coordination ◽  
Rib Cage ◽  
Relative Contribution ◽  
Volume Functional ◽  
Residual Capacity ◽  
Anesthetized Dogs ◽  
Expiratory Muscles

Active expiration is produced by the abdominal muscles and the rib cage expiratory muscles. We hypothesized that the relative contribution of these two groups to expiration would affect diaphragmatic length and, hence, influence the subsequent inspiration. To address this question we measured the respiratory muscle response to expiratory threshold loading in spontaneously breathing anesthetized dogs. Prevagotomy, the increase in lung volume (functional residual capacity) and decrease in initial resting length of the diaphragm were attenuated by greater than 50% of values predicted by the passive relationships. Diaphragmatic activation (electromyogram) increased and tidal volume (VT) was preserved. Postvagotomy, effective expiratory muscle recruitment was abolished. The triangularis sterni muscle remained active, and the increase in lung volume was attenuated by less than 15% of that predicted by the passive relationship. Diaphragmatic length was shorter than predicted. VT was not restored, even though costal diaphragmatic and parasternal intercostal electromyogram increased. During expiratory threshold loading with abdominal muscles resected and vagus intact, recruitment of the rib cage expiratory muscles produced a reduction in lung volume comparable with prevagotomy; however, diaphragmatic length decreased markedly. Both the rib cage and abdominal expiratory muscles may defend lung volume; however, their combined action is important to restore diaphragmatic initial length and, accordingly, to preserve VT.

scholarly journals Assessment of the influence of lung inflation state on the quantitative parameters derived from hyperpolarized gas lung ventilation MRI in healthy volunteers

2019 ◽  
Vol 126 (1) ◽  
pp. 183-192 ◽  
Author(s):  
Paul J. C. Hughes ◽  
Laurie Smith ◽  
Ho-Fung Chan ◽  
Bilal A. Tahir ◽  
Graham Norquay ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
Lung Volume ◽  
Lung Ventilation ◽  
Lung Volumes ◽  
Lung Inflation ◽  
Longitudinal Measurements ◽  
Anatomical Images ◽  
Lower Lung ◽  
Ventilation Heterogeneity ◽  
Residual Capacity

In this study, the effect of lung volume on quantitative measures of lung ventilation was investigated using MRI with hyperpolarized 3He and 129Xe. Six volunteers were imaged with hyperpolarized 3He at five different lung volumes [residual volume (RV), RV + 1 liter (1L), functional residual capacity (FRC), FRC + 1L, and total lung capacity (TLC)], and three were also imaged with hyperpolarized 129Xe. Imaging at each of the lung volumes was repeated twice on the same day with corresponding 1H lung anatomical images. Percent lung ventilated volume (%VV) and variation of signal intensity [heterogeneity score (Hscore)] were evaluated. Increased ventilation heterogeneity, quantified by reduced %VV and increased Hscore, was observed at lower lung volumes with the least ventilation heterogeneity observed at TLC. For 3He MRI data, the coefficient of variation of %VV was <1.5% and <5.5% for Hscore at all lung volumes, while for 129Xe data the values were 4 and 10%, respectively. Generally, %VV generated from 129Xe images was lower than that seen from 3He images. The good repeatability of 3He %VV found here supports prior publications showing that percent lung-ventilated volume is a robust method for assessing global lung ventilation. The greater ventilation heterogeneity observed at lower lung volumes indicates that there may be partial airway closure in healthy lungs and that lung volume should be carefully considered for reliable longitudinal measurements of %VV and Hscore. The results suggest that imaging patients at different lung volumes may help to elucidate obstructive disease pathophysiology and progression. NEW & NOTEWORTHY We present repeatability data of quantitative metrics of lung function derived from hyperpolarized helium-3, xenon-129, and proton anatomical images acquired at five lung volumes in volunteers. Increased regional ventilation heterogeneity at lower lung inflation levels was observed in the lungs of healthy volunteers.

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