Pericapillary Gas and Water Distribution Volumes of the Lung Calculated from Multiple Indicator Dilution Curves

Ramsey, Lloyd H.; Puckett, Walter; Jose, Anthony D.; Lacy, William W.

doi:10.1161/01.res.15.4.275

Cited by 24 publications

(9 citation statements)

References 12 publications

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“…Therefore, the technique should detect an increased vascular leak in pathological states in humans in which there is loss of integrity of the pulmonary vessels whether or not pressures are increased. Similar studies with other indicators have been carried out in living humans with little morbidity (33,34).…”

Section: Resultssupporting

confidence: 67%

“…The distribution volumes of lung water, determined by this technique, are not limited by the diffusion rate of tritiated water (32)(33)(34), but are uniformly smaller than lung water content determined by postmortem dessication (6,35,36). This discrepancy has been attributed to hypoperfusion and "inaccessible" water (6,34) 40 uCi tritiated water (THO), and 10 ptCi ["C]urea were added to these labeled cells.…”

Section: Introductionmentioning

confidence: 98%

“…Immediately before each dilution curve, arterial blood samples were taken for determination of background activities of the isotopes and hematocrit, and an anaerobic sample collected for measurement of Pco2, Po,, and pH that were determined with Instrumentation Laboratory model S113 blood gas analyzer (Instrumentation Laboratory, Inc., Lexington, Mass.). For each dilution curve, 3.0 ml of the injectate was rapidly injected as a bolus into the right atrial catheter (catheter vol = 0.43 ml), afterwards 1.2-ml samples were drawn at 1-s intervals from the catheter in the terminal aorta using an automatic syringe sampler described by Ramsey, Puckett, Jose, and Lacy (33 Relative concentration, expressed as a ratio of counts for each indicator in each sample to the total counts of that indicator injected, was plotted on a logarithmic scale against a linear time scale; the downslopes were extrapolated linearly using a least-squares line and calculations of area, flow, and mean transit time were made as described by Ramsey et al (33). The difference between mean transit time volumes of any two indicators was taken as the product of the difference in their mean transit times and flow determined from the red cell curves.…”

Section: Introductionmentioning

confidence: 99%

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In Vivo Assessment of Pulmonary Vascular Integrity in Experimental Pulmonary Edema

Brigham¹,

Snell²

1973

J. Clin. Invest.

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A B S T R A C T During single pass indicator studies across the lungs ["C]urea remains in the vascular compartment, but its molecular size and solubility suggest it might escape abnormally permeable vessels. To test the hypothesis that ["C]urea might be used to distinguish pulmonary edema due to acutely increased intravascular pressure from that due to vascular damage by alloxan, we studied [5tCr]erythrocytes (r), ['I]albumin (a), ["C]urea (u), and tritiated water as dilution indicators in the pulmonary circulation of anesthetized dogs. In addition, the adequacy of albumin as an intravascular indicator was evaluated.Indicator curves, blood gases, hematocrit, and vascular pressures were determined during a base-line period and repeated 30 and 60 min after treatment in five groups of dogs: (a) saline control, (b) alloxan edema, (c) epinephrine infusion, (d) volume overload, and (e) left atrial (LA) balloon obstruction.Groups b, d, and e developed a similar degree of edema judging by wet/dry lung weights and histology. Groups a and c did not develop edema. In alloxan edema, differences between the mean transit time volume of u and r (V.-.) increased over base line at 30 (P < 0.01 ) and 60 min (P < 0.02); the differences between the mean transit time volume of a and r (V.-,) increased slightly at 30 (P < 0.03) and 60 min (P <0.02); and V.-, significantly exceeded V.-, at 30 (mean difference = 9 ml, P < 0.02) and 60 min (mean difference = 11, P < 0.04). In none of the other groups did V.-, significantly exceed V.-,. Thus, comparison of V.-, with V.-, may permit distinction between "high pressure" and "increased permeability" pulmonary edema.Albumin was not a consistently reliable indicator of intravascular volume as compared with composite red cell and albumin curve.

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Section: Resultssupporting

confidence: 67%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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In Vivo Assessment of Pulmonary Vascular Integrity in Experimental Pulmonary Edema

Brigham¹,

Snell²

1973

J. Clin. Invest.

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“…• Pulmonary extravascular water volume (PEWV) can be calculated from the difference between the downstream dilution curves of tritiated water (THO) and an intravascular indicator after their simultaneous injection into the right side of the heart (1)(2)(3). This technique has been used to measure pulmonary edema in experimental animals and humans (4)(5)(6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

On Defining the Pulmonary Extravascular Water Volume

Brigham

Ramsey

Snell

et al. 1971

Circulation Research

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To evaluate the effect of diffusion on the pulmonary extravascular water volume determined from indicator dilution studies, simultaneous comparisons of the pulmonary extravascular distribution volumes of tritiated water (THO) and of three lipid soluble substances with higher molecular weights were made. In 21 studies on pentobarbital-anesthetized dogs, the distribution volume of antipyrine (AP) was slightly smaller tlian that of THO (mean difference = 2.86 ml ± 1.49 SE ; 0 . 1 > P > 0 . 0 5 ) . The results of 21 studies in conscious humans showed a slightly smaller distribution volume for 131 Iiodoantipyrine (IAP) than for THO (mean difference = 15.62 ml it 3.36 SE; P < 0 . 0 1 ) . Neither the differences between THO and AP in dogs nor those between IAP and THO in humans correlated with either flow (r = 0.25 for dog studies; r = 0.07 for human studies) or the mean transit time of the intravascular indicator (r = -0.17 for dog studies; r = 0.14 for human studies). No significant difference between the distribution volume of 14 C-ethanol (ETOH) and THO could be shown in either dogs (12 studies) or humans (15 studies). Relative lung-to-blood partitioning of IAP as compared to THO at equilibrium in dogs was 0.92 ±0.08; the same value for ETOH was 1.18 ± 0.10. The findings strongly suggest that distribution volume for these indicators is independent of their diffusion characteristics and that IAP may be a reasonable substitute for THO in measuring pulmonary extravascular water volume.

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“…In the two patients who made uneventful recoveries, Vt was found to be 144 nil/M2, while in five comparable individuals, the tritiated water space after correction for water in blood was 112 ml/m2 (20). The predicted normal parenchymal volume is 259 ml/M2 (22).…”

Section: Resultsmentioning

confidence: 87%

Indicator Dilution Measurements of Lung Volumes and Alveolar Air Exchange During Breathing

Hechtman¹,

Reid²,

Dorn³

et al. 1973

J. Clin. Invest.

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A B S T R A C T A new triple tracer indicatorIn control studies, VAxC was similar to VACo2, obtained with the steady-state CO2 method (r = 0.87), while in critically ill patients the xenon measurement was significantly lower, averaging 54% of VAco2. In theory, underestimates in VAxC and decrease in the ratio VAX,/VAco2 relate to nonuniformity in regional ventilation and perfusion. The effect is greatest for the slightly soluble gas, xenon. The significant inverse correlation between .VAxe/ViAco2 and the physiologic shunt is consistent with this postulate.FRCxe was similar to the predicted FRC in animals but was 76% of the helium measured FRC in patients. FRCxe was significantly lower than the xenon measured air volumes during breath-holding when nonuniformity of ventilation was not operative. Lung tissue volumes in animals were 83%7o of gravimetric lung weights, while in patients the volumes were much lower than predicted. Nonhomogeneous lung function, including failure to perfuse the entire capillary bed, with resultant

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Pericapillary Gas and Water Distribution Volumes of the Lung Calculated from Multiple Indicator Dilution Curves

Cited by 24 publications

References 12 publications

In Vivo Assessment of Pulmonary Vascular Integrity in Experimental Pulmonary Edema

In Vivo Assessment of Pulmonary Vascular Integrity in Experimental Pulmonary Edema

On Defining the Pulmonary Extravascular Water Volume

Indicator Dilution Measurements of Lung Volumes and Alveolar Air Exchange During Breathing

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