Pulmonary tissue volume (Vt) and pulmonary capillary blood flow (Qc) were measured in anesthetized dogs by analyzing end-expiratory concentrations of dimethyl ether (DME), acetylene (C2H2), and sulfur hexafluoride during a 30-s rebreathing maneuver. Vt was compared to the postmortem lung weight of control dogs and dogs with hemodynamic and nonhemodynamic (alloxan) pulmonary edema. Qc was compared to the cardiac output measured by dye dilution. A 100-ml increase in alveolar volume (VA) in the range of 1-2 liters resulted in a 9 +/- 3 ml increase in Vt. Vt measured at a VA of 1.9 liters measures 114 +/- 18% of the postmortem lung weight in 20 control dogs and in 6 dogs with moderate edema (lung weight < 250% of predicted). Vt measured only 53 +/- 14% of the lung weight in 11 dogs with more severe edema. DME and C2H2 gave the smae mean values of Vt, but the reproducibility of a series of 3-7 measurements was greater with DME (coefficient of variation was 5% with DME and 8% C2H2). Qc measured 96 +/ 15% of the cardiac output during the rebreathing maneuver, but the maneuver caused a 4-40% fall in the cardiac output. These data show that Vt determined by rebreathing DME is between 86% and 135% of the lung weight in dogs with pulmonary edema until the lung weight is greater than 250% of the predicted value.
The hemodynamic effects of butorphanol, a potent synthetic narcotic-antagonist analgesic, were investigated and compared with those of morphine. A total of 20 patients were studied (8 butorphanol, 12 morphine) at the time of diagnostic cardiac catheterization. Butorphanol decreased pH, PCO2, and systemic artery pressure and increased PCO2, cardiac index, and pulmonary artery pressure. Morphine caused similar changes in pH, PO2, systemic artery pressure, and PCO2 but much smaller changes in cardiac index and no change in pulmonary artery pressure. The clinical implications and possible mechanisms are discussed.
Twenty-two patients were studied during hospital admission for cardiac catheterization. Two independent observers rated their behavior at 15-min intervals over the 3-hour catheterization procedure in categories of affect, arousal and degree of interpersonal engagement. These rated data were used together with information obtained from retrospective interviews to assign each patient to one of the behavioral groups designated anxious-engaged, anxious-not engaged, depressed and calm. Plasma levels of growth hormone, cortisol, free fatty acid and glucose were determined every 30 min during the procedure. Free fatty acid levels rose appreciably in all patients. Calm and depressed patients showed no significant increases in plasma levels of either growth hormone or cortisol. Anxious-engaged patients showed elevations of cortisol but no elevation of growth hormone. Anxious-not engaged patients showed elevations of both growth hormone and cortisol. The several patterns of hormonal change may reflect different neural organizations underlying the several types of coping behavior.Plasma growth hormone levels in man are labile and have been shown to increase in response to different stimuli such as insulin-induced hypoglycemia, surgical pro-
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