Effects of Unilateral Hypoxic Ventilation upon Pulmonary Hemodynamics and Intrapulmonary Shunt in Dogs

1983 ◽  
Vol 16 (4) ◽  
pp. 284
Author(s):  
Moo II Kwon ◽  
Kwang Woo Kim
1991 ◽  
Vol 260 (4) ◽  
pp. H1080-H1086 ◽  
Author(s):  
S. Brimioulle ◽  
J. L. Vachiery ◽  
P. Lejeune ◽  
M. Leeman ◽  
C. Melot ◽  
...  

The effects of acidosis and alkalosis on pulmonary gas exchange were studied in 32 pentobarbital sodium-anesthetized intact dogs after induction of oleic acid (0.06 ml/kg) pulmonary edema. Gas exchange was assessed at constant ventilation and constant cardiac output, by venous admixture calculations and by intrapulmonary shunt measurements using the sulfur hexafluoride (SF6) method. Metabolic acidosis (pH 7.20) and alkalosis (pH 7.60) were induced with HCl and Carbicarb (isosmolar Na2CO3 and NaHCO3), respectively. Hypercapnia was induced by adding inspiratory CO2, whereas pH was allowed to change (respiratory acidosis, pH 7.20) or maintained constant (isolated hypercapnia). Mean intrapulmonary shunt and pulmonary arterial minus wedge pressure difference, respectively, changed from 44 to 33% (P less than 0.05) and from 9 to 10 mmHg (P greater than 0.05) in metabolic acidosis, from 44 to 62% (P less than 0.001) and from 12 to 8 mmHg (P less than 0.01) in metabolic alkalosis, from 40 to 42% (P greater than 0.05) and from 13 to 16 mmHg (P less than 0.05) in respiratory acidosis, from 42 to 52% (P less than 0.05) and from 8 to 12 mmHg (P less than 0.01) in isolated hypercapnia. These results indicate that acidosis, alkalosis, and hypercapnia markedly influence pulmonary gas exchange and/or pulmonary hemodynamics in dogs with oleic acid pulmonary edema.


1995 ◽  
Vol 78 (4) ◽  
pp. 1531-1536 ◽  
Author(s):  
R. Rossaint ◽  
S. M. Hahn ◽  
D. Pappert ◽  
K. J. Falke ◽  
P. Radermacher

In 12 patients undergoing extracorporeal membrane oxygenation for treatment of severe acute respiratory distress syndrome (ARDS), we examined the effects of independent variations in mixed venous oxygen tension (PvO2) and inspired oxygen fraction (FIO2) on the distribution of ventilation and perfusion as assessed by the multiple inert gas elimination technique. Reducing the oxygen concentration of the constant gas stream through the membrane lungs allowed us to decrease the PvO2 by approximately 20 Torr independently of variations in cardiac output and FIO2 as well as to augment FIO2 without influencing PvO2. The interventions did not induce any change in heart rate or systemic or pulmonary hemodynamics. In general, neither during mechanical ventilation at FIO2 of 0.6 nor during mechanical ventilation at FIO2 of 1.0 did the reduced PvO2 cause variations in the distribution of pulmonary blood flow in our patients with severe ARDS. Nevertheless, in individual patients, decreasing PvO2 or ventilation at FIO2 of 1.0 was associated with changes in intrapulmonary shunt. Therefore, we conclude that it is not possible to predict the influence of such interventions in pulmonary gas exchange in the individual patient suffering from ARDS. Differences in the regulation of the local distribution of blood flow caused by the disease itself might explain this phenomenon.


2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
V Kaur ◽  
A Manouras ◽  
A Venkateshvaran

Abstract Funding Acknowledgements Type of funding sources: None. Background. Symptomatic rheumatic mitral stenosis (MS) results in elevation in left atrial (LA) pressure that is passively transmitted to derange pulmonary hemodynamics and subsequently elevate right ventricular afterload. We studied associations between LA to right atrial reservoir strain ratio (LA-RAs) and invasive pulmonary hemodynamics in addition to the ratio’s ability to identify subjects with elevated pulmonary vascular resistance (PVR). Methods.  Consecutive MS subjects undergoing right heart catheterization (RHC) and percutaneous transvenous mitral commissurotomy (PTMC) were enrolled. Subjects with atrial fibrillation, >mild mitral regurgitation, concomitant aortic valve or ischemic heart disease were excluded. LA-RAs was assessed by speckle-tracking echocardiography and stratified into high or low LA-RAs subgroups based on mean value. Correlations with invasive pulmonary hemodynamics was studied. ROC analysis was performed to identify pulmonary hypertension (PH) and PVR > 3 Wood Units. Results. 110 subjects were analysed (age: 32 ± 8; 72% female). LA and RA reservoir strain was feasible in 88 (80%) and 83 (75%) subjects respectively. Patients with low LA-RAs demonstrated more severe MS (0.8 ± 0.1 vs. 1.0 ± 0.2cm2), higher mean pulmonary artery (43 ± 13 vs. 33 ± 13mmHg) and capillary wedge pressure (28 ± 6 vs.23 ± 16mmHg) as compared with high LA-RAs (p < 0.001 for all). LA-RAs was associated with invasive PA systolic (r=-0.30;p = 0.05), diastolic (r=-0.28;p = 0.02) and mean (r=-0.33; p = 0.002) pressures, demonstrated modest ability to identify elevated PVR (AUC = 0.65;p = 0.03) and strong ability to identify PH (AUC = 0.75; p < 0.001). LA-RAs significantly increased after PTMC (0.43 ± 0.1 to 0.52 ± 0.1;p < 0.001). Conclusions. The novel atrial strain ratio is associated with measures of invasive pulmonary hemodynamics and demonstrates ability to identify PH and elevated PVR in MS.


2021 ◽  
Vol 5 (1) ◽  
pp. 65-68
Author(s):  
Saad Khoshhal ◽  
Mansour Al‐Mutairi ◽  
Mohamed Morsy ◽  
Nasser Kreary ◽  
Abdulhameed Alnajjar ◽  
...  

1986 ◽  
Vol 61 (1) ◽  
pp. 331-337 ◽  
Author(s):  
A. W. Smits ◽  
N. H. West ◽  
W. W. Burggren

Pulmonary hemodynamics and net transcapillary fluid flux (NTFF) were measured in conscious toads before and following bilateral denervation of the recurrent laryngeal nerves (rLN), which contain afferents from baroreceptors located in the pulmocutaneous arteries. Denervation caused an acute doubling of the arterial-venous pressure gradient across the lung and a threefold increase in pulmonary blood flow. Calculated pulmonary vascular resistance fell and remained below control values through the period of experimentation. NTFF increased by an order of magnitude (0.74–7.77 ml X kg-1 X min-1), as filtration increased in response to the hemodynamic changes caused by rLN denervation. There was a better correlation between NTFF and pulmonary blood flow than between NTFF and pulmonary driving pressure. Our results support the view that tonic neural input from pulmocutaneous baroreceptors protects the anuran lung from edema by restraining pulmonary driving pressure and blood flow and perhaps by reflexly maintaining vascular tone in the extrinsic pulmonary artery, therefore tending to increase the pre-to-postpulmonary capillary resistance ratio and biasing the Starling relationship in the pulmonary capillaries against filtration.


1989 ◽  
Vol 257 (2) ◽  
pp. H415-H422 ◽  
Author(s):  
B. R. Walker ◽  
J. Haynes ◽  
H. L. Wang ◽  
N. F. Voelkel

Experiments were performed to determine the pulmonary vascular responses to exogenous or endogenous arginine vasopressin (AVP) in rats. Both in vitro and in vivo approaches were used to examine the direct pulmonary vasoactive properties of AVP and how those properties affect pulmonary hemodynamics in the intact animal. In conscious, unrestrained rats, constant infusion of AVP (4.0 mU.kg-1.min-1 iv) resulted in a fall in mean pulmonary artery pressure (PAP), although systemic pressure was increased. Coincident with the fall in PAP were similar reductions in cardiac output and heart rate. Similarly, bolus administration of AVP reduced PAP, and this effect was augmented during hypoxia. Another series of experiments examined the effect of endogenous AVP released by arterial hypoxemia on pulmonary hemodynamics in conscious rats. Administration of a specific V1-vasopressinergic antagonist had no effect on the PAP response to hypoxia; however, systemic resistance tended to fall following V1-antagonism. To determine the vasoactive properties of AVP independent of these changes in blood flow, a series of experiments were performed on isolated, perfused rat lungs. Injection of 25, 200, or 2,000 mU of AVP into the circulation of the isolated lung was without effect under normoxic conditions. In contrast, 25 mU AVP elicited reproducible pulmonary vasodilation when injected during ongoing hypoxic pulmonary vasoconstriction. This vasodilatory response was unaffected by meclofenamate or by the platelet-activating factor receptor antagonist SRI 63-441, but was blocked by a specific V1-vasopressinergic antagonist. We conclude that although AVP exerts profound systemic vasoconstriction, the pulmonary circulation appears relatively unaffected by exogenous or endogenous AVP in vivo.(ABSTRACT TRUNCATED AT 250 WORDS)


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