scholarly journals The effect of acute ventilation-perfusion mismatch on respiratory heat exchange in a porcine model

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254399
Author(s):  
Maximilian Edlinger-Stanger ◽  
Martin-Hermann Bernardi ◽  
Katharina Kovacs ◽  
Michael Mascha ◽  
Thomas Neugebauer ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Heat Exchange ◽  
Pulmonary Artery ◽  
Lung Ventilation ◽  
Left Pulmonary Artery ◽  
Lung Lavage ◽  
Whole Lung Lavage ◽  
High Cardiac Output ◽  
Single Lung Ventilation ◽  
Respiratory Heat Exchange

Background Respiratory heat exchange is an important physiological process occurring in the upper and lower respiratory tract and is usually completed when inspired gases reach the alveoli. Animal and human studies demonstrated that heat exchange can be modulated by altering pulmonary ventilation and perfusion. The purpose of this study was to examine the effect of acute ventilation-perfusion (V/Q) mismatch on respiratory heat exchange. In clinical practice, monitoring respiratory heat exchange might offer the possibility of real-time tracking of acute V/Q-mismatch. Methods In 11 anesthetized, mechanically ventilated pigs, V/Q-mismatch was established by means of four interventions: single lung ventilation, high cardiac output, occlusion of the left pulmonary artery and repeated whole-lung lavage. V/Q-distributions were determined by the multiple inert gas elimination technique (MIGET). Respiratory heat exchange was measured as respiratory enthalpy using the novel, pre-commercial VQm™ monitor (development stage, Rostrum Medical Innovations, Vancouver, CA). According to MIGET, shunt perfusion of low V/Q compartments increased during single lung ventilation, high cardiac output and whole-lung lavage, whereas dead space and ventilation of high V/Q compartments increased during occlusion of the left pulmonary artery and whole-lung lavage. Results Bohr dead space increased after pulmonary artery occlusion and whole-lung lavage, venous admixture increased during single lung ventilation and whole-lung lavage, PaO2/FiO2 was decreased during all interventions. MIGET confirmed acute V/Q-mismatch. Respiratory enthalpy did not change significantly despite significant acute V/Q-mismatch. Conclusion Clinically relevant V/Q-mismatch does not impair respiratory heat exchange in the absence of additional thermal stressors and may not have clinical utility in the detection of acute changes.

Pulmonary artery catheter monitoring during single-lung ventilation in dogs

1992 ◽  
Vol 8 (3) ◽  
pp. 209-215 ◽  
Author(s):  
Charles Boucek ◽  
Miroslav Klain ◽  
Nancy Obuchowski ◽  
Renee Molner
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Artery Catheter ◽  
Lung Ventilation ◽  
Single Lung Ventilation

Measuring cardiac output in one-lung ventilation: a comparison of pulmonary artery and transpulmonary aortic measurements in pigs

2004 ◽  
Vol 18 (2) ◽  
pp. 190-193 ◽  
Author(s):  
Lars Hüter ◽  
Konrad Schwarzkopf ◽  
Niels-Peter Preussler ◽  
Elke Gaser ◽  
Harald Schubert ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Pulmonary Artery ◽  
Lung Ventilation ◽  
One Lung Ventilation

Measurement of bronchial blood flow with radioactive microspheres in awake sheep

1988 ◽  
Vol 65 (3) ◽  
pp. 1131-1139 ◽  
Author(s):  
C. H. Wu ◽  
D. C. Lindsey ◽  
D. L. Traber ◽  
C. E. Cross ◽  
D. N. Herndon ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cardiac Output ◽  
Pulmonary Artery ◽  
Left Lung ◽  
Arterial Occlusion ◽  
Left Pulmonary Artery ◽  
Right Atrial ◽  
Significant Difference ◽  
Microsphere Method ◽  
Pulmonary Arterial

Distribution of bronchial blood flow was measured in unanesthetized sheep by the use of two modifications of the microsphere reference sample technique that correct for peripheral shunting of microspheres: 1) A double microsphere method in which simultaneous left and right atrial injections of 15-microns microspheres tagged with different isotopes allowed measurement of both pulmonary blood flow and shunt-corrected bronchial blood flow, and 2) a pulmonary arterial occlusion method in which left atrial injection and transient occlusion of the left pulmonary artery prevented delivery to the lung of microspheres shunted through the peripheral circulation and allowed systemic blood flow to the left lung to be measured. Both methods can be performed in unanesthetized sheep. The pulmonary arterial occlusion method is less costly and requires fewer calculations. The double microsphere method requires less surgical preparation and allows measurement without perturbation of pulmonary hemodynamics. There was no statistically significant difference between bronchial blood flow measured with the two methods. However, total bronchial blood flow measured during pulmonary arterial occlusion (1.52 +/- 0.98% of cardiac output, n = 9) was slightly higher than that measured with the double microsphere method (1.39 +/- 0.88% of cardiac output, n = 9). In another series of experiments in which sequential measurements of bronchial blood flow were made, there was a significant increase of 15% in left lung bronchial blood flow during the first minute of occlusion of the left pulmonary artery. Thus pulmonary arterial occlusion should be performed 5 s after microsphere injection as originally described by Baile et al. (1).(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiovascular dynamics of the chelonia during apnoea and lung ventilation

1976 ◽  
Vol 64 (2) ◽  
pp. 323-343 ◽  
Author(s):  
G. Shelton ◽  
W. Burggren
Keyword(s):  
Heart Rate ◽  
Cardiac Output ◽  
Pulmonary Artery ◽  
Single Ventricle ◽  
Lung Ventilation ◽  
Pulmonary Flow ◽  
Flow Profiles ◽  
Large Fluctuations ◽  
Blood Pressures ◽  
Systemic Arteries

1. In both Pseudemys and Testudo, blood pressures are identical in all chambers of the ventricle. Systolic pressures are not measurably different in the ventricle and systemic arteries but are 0–5-2-0 cm H2O lower in the pulmonary artery due to the resistance of the pulmonary outflow tract. Diastolic pressures are the same in all systemic arteries but are substantially lower in the pulmonary artery. It is concluded that the systemic and pulmonary circulations are perfused by a single pump during both apnoea and lung ventilation. 2. Flow profiles in pulmonary and systemic arteries are characteristicallly different. Substantial changes in cardiac output may occur during intermittent breathing and apnoea, especially if there are large fluctuations in heart rate. Pulmonary flow increases during lung ventilation due to vasodilation of the lung vasculature. Systemic is also affected though the increase is usually smaller. 3. Any separation in the blood pumped by the single ventricle must be maintained by laminar flow patterns and the composition of the blood in each of the major arteries should reflect their relationship to these patterns.

Unintended Pulmonary Artery Ligation during PDA Ligation

2016 ◽  
Vol 19 (4) ◽  
pp. 187 ◽  
Author(s):  
Dohun Kim ◽  
Si-Wook Kim ◽  
Hong-Ju Shin ◽  
Jong-Myeon Hong ◽  
Ji Hyuk Lee ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Ductus Arteriosus ◽  
Left Lung ◽  
Left Pulmonary Artery ◽  
Chest Ct ◽  
Mechanical Ventilator ◽  
Artery Ligation ◽  
Ventilator Support ◽  
Surgical Ligation ◽  
Emergent Operation

A 10-day-old boy was transferred to our hospital due to tachypnea. Patent ductus arteriosus (PDA), 4.8 mm in diameter, with small ASD was diagnosed on echocardiography. Surgical ligation of the ductus was performed after failure of three cycles of ibuprofen. However, the ductus remained open on routine postoperative echocardiography on the second postoperative day, and chest CT revealed inadvertent ligation of the left pulmonary artery (LPA) rather than the PDA. Emergent operation successfully reopened the clipped LPA and ligated the ductus on the same (second postoperative) day.<br />Mechanical ventilator support was weaned on postoperative day 21, and the baby was discharged on postoperative day 47 with a normal left lung shadow.

Ligation of left pulmonary artery instead of patent ductus arteriosus

2020 ◽  
Vol 30 (12) ◽  
pp. 1943-1945
Author(s):  
Semih Murat Yucel ◽  
Irfan Oguz Sahin
Keyword(s):  
Surgical Treatment ◽  
Pulmonary Artery ◽  
Patent Ductus Arteriosus ◽  
Surgical Complication ◽  
Ductus Arteriosus ◽  
Left Pulmonary Artery ◽  
Artery Ligation ◽  
Surgical Closure ◽  
Post Operative Period ◽  
Patent Ductus

AbstractDuctus arteriosus is an essential component of fetal circulation. Due to occurring changes in the cardiopulmonary system physiology after birth, ductus arteriosus closes. Patent ductus arteriosus can be closed by medical or invasive (percutaneous or surgical) treatment methods. Percutaneous or surgical closure of patent ductus arteriosus can be performed for the cases that medical closure failed. Surgical treatment is often preferred method for closure of patent ductus arteriosus in the neonatal period. The most common surgical complications are pneumothorax, recurrent laryngeal nerve injury, bleeding, and recanalisation. A very rare surgical complication is left pulmonary artery ligation that has been presented in a few cases in the literature. Echocardiography control should be performed in the early post-operative period, especially in patients with clinical suspicion. If reoperation is required, it should never be delayed. We report a newborn patient whose left pulmonary artery ligated accidentally during patent ductus arteriosus closure surgery and surgical correction of this complication at the early post-operative period.

scholarly journals Spontaneous pulmonary artery thrombus in a neonate

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Y. S. Shrimanth ◽  
Krishna Prasad ◽  
Adari Appala Karhtik ◽  
Parag Barwad ◽  
C. R. Pruthvi ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Respiratory Distress ◽  
Disease Risk ◽  
Maternal Diabetes ◽  
Left Pulmonary Artery ◽  
Pulmonary Angiography ◽  
Haemodynamic Instability ◽  
Artery Thrombosis ◽  
Heart Disease Risk Factors ◽  
Heart Disease Risk

Abstract Background Pulmonary artery thrombosis is rare in neonates and mimics as persistent pulmonary hypertension or congenital heart disease. Risk factors include septicemia, dehydration, polycythemia, maternal diabetes, asphyxia, and inherited thrombophilias. They present with cyanosis and respiratory distress. Careful echocardiogram assessment helps in identifying the thrombus in the pulmonary artery and its branches. Computed tomography pulmonary angiography confirms the diagnosis. Case presentation We present a case of term neonate who presented with respiratory distress and cyanosis and a detailed echocardiogram revealed thrombus in the origin of left pulmonary artery. The neonate was managed initially with unfractionated heparin and later with low molecular weight heparin with which there was significant resolution of the thrombus Conclusion Spontaneous pulmonary artery thrombosis though rare should be suspected in any cyanotic neonate with respiratory distress. Management in these cases depends on the haemodynamic instability and lung ischemia.

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