Pulmonary and Circulatory Effects of Acute Pulmonary Vascular Engorgement in Normal Subjects 1

Bondurant, Stuart; Hickam, John B.; Isley, Joseph K.

doi:10.1172/jci103410

Cited by 80 publications

(33 citation statements)

References 13 publications

(15 reference statements)

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“…The degree of reduction of pulmonary compliance with pulmonary venous engorgement observed is of a considerably smaller magnitude than that reported by Bondurant, Hickam, and Isley in normal human subjects following acute central congestion, produced either by inflation of an antigravity suit or submersion in water (7). In the present studies, pulmonary compliance decreased not more than 30 per cent when left atrial pressures were increased to 60 cm.…”

Section: 0^contrasting

confidence: 72%

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The Effect of Pulmonary Vascular Pressures on the Mechanical Properties of the Lungs of Anesthetized Dogs1

Borst¹,

Berglund²,

Whittenberger³

et al. 1957

J. Clin. Invest.

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Since the experiments of von Basch (1) it has been recognized that pulmonary vascular congestion influences the mechanical behavior of the lungs. A number of studies in patients with chronic congestive failure have demonstrated marked changes in pulmonary elasticity (2-6). It has not been possible to determine in such patients the relative contributions of pulmonary edema, other parenchymal changes, and vascular congestion per se to the observed changes. Experiments with acute congestion in man or living animals (7-10) and isolated lungs (11) have yielded conflicting results.The purpose of the present study was to examine in the living animal the effects of acute changes in pulmonary arterial and venous pressures and blood flow on the mechanical behavior of the lungs. The left atrial pressure and the pulmonary blood flow were varied independently. In one set of experiments, volume-pressure curves were obtained during stepwise inflation and deflation of the lung over a wide range of volume starting from the passively collapsed state. In another group, pulmonary compliance and flow-resistance were studied during continuous cycling of the lungs in the normal tidal range of lung volume. Nembutal@ (25 to 45 mg. per Kg. body weight, intravenously). The chest was opened by splitting the sternum, and the chest wall was retracted to minimize crowding of the intrathoracic viscera during inflation of the lungs. The right ventricle was replaced by a pump without interruption of the circulation as in an experimental preparation previously described (12). Systemic venous blood was diverted into a reservoir from which it was pumped into either the main pulmonary artery or into the two pulmonary artery branches separately.When both pulmonary arteries were cannulated, the blood flow in the lung to be studied was varied by changing distribution of flow. In addition, pulmonary flow could be varied by changing pump output. Left atrial pressure was varied by mechanically altering the systemic arterial resistance (constriction of the ascending aorta, inflation of balloon in ascending aorta, systemic A-V shunt). Sometimes additional adjustment of left atrial pressure was obtained with an overflow system between the left atrium and the venous reservoir. In this way changes could be made in pulmonary flow or left atrial pressure independent of each other.Pulmonary blood flows were measured with rotameters. Pressures in the pulmonary arteries distal to the respective cannulae, in the left atrium, and in the femoral or carotid arteries were measured with electromanometers. These values were recorded on a direct-writing Sanborn oscillograph.Two methods were used to measure the mechanical characteristics of the lung.

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Section: 0^contrasting

confidence: 72%

“…It has not been possible to determine in such patients the relative contributions of pulmonary edema, other parenchymal changes, and vascular congestion per se to the observed changes. Experiments with acute congestion in man or living animals (7)(8)(9)(10) and isolated lungs (11) have yielded conflicting results.…”

mentioning

confidence: 99%

The Effect of Pulmonary Vascular Pressures on the Mechanical Properties of the Lungs of Anesthetized Dogs1

Borst¹,

Berglund²,

Whittenberger³

et al. 1957

J. Clin. Invest.

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“…The dependence in man of dynamic CL upon pulmonary vascular pressure, or volume, or both, was shown by Bondurant and co-workers (7,39,40), who produced acute central vascular engorgement by G-suit inflation and decreased CL by this maneuver. The effects of atropine on CL suggest that, just as increased pulmonary vascular pressures decrease CL, decreased pulmonary vascular pressures and volume increase CL.…”

Section: Discussionmentioning

confidence: 84%

The Effect of Changes in the Pulmonary Vascular Bed Produced by Atropine, Pulmonary Engorgement, and Positive-Pressure Breathing on Diffusing and Mechanical Properties of the Lung*

Daly¹,

Ross²,

Behnke³

1963

J. Clin. Invest.

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Several factors probably have some role in determining the volume of the effectively ventilated pulmonary capillary bed, including pulmonary blood flow, pulmonary vascular pressures, pulmonary blood volume, alveolar and blood gas tensions, and mechanical effects of ventilation.Others have found that atropine sulfate, 2.0 mg iv, increases cardiac output (1, 2), decreases central venous pressure (1, 2), and affects the distribution of the blood volume as shown by plethysmographic study of extremity venous volume (3). This drug, then, provides an unusual rearrangement of some of the determinants of pulmonary capillary function and, for the present study, was used either alone or in combination with positivepressure breathing or pulmonary vascular engorgement produced by G-suit inflation.This study was carried out to provide further information concerning the interaction of cardiac output, pulmonary vascular pressure, and pulmonary blood volume as determinants of the volume of effectively ventilated capillaries by de-termining the effects of changes in the pulmonary vascular bed produced by atropine, pulmonary engorgement, and positive-pressure breathing on the diffusing and mechanical properties of the lung.

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“…It seemed unlikely that the changes were the result of pulmonary vascular engorgement, because the increase in venous pressure was slight in contrast to that obtained under different conditions (22). It An observation which pointed toward a change in the number of ventilated lung units was the release of nitrogen in association with the recovery of the normal pressure-volume relationship of the lung.…”

Section: Discussionmentioning

confidence: 90%

Some Effects of Restriction of Chest Cage Expansion on Pulmonary Function in Man: An Experimental Study*†

Colin¹,

Butler²,

DuBois³

1960

J. Clin. Invest.

203

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Pulmonary and Circulatory Effects of Acute Pulmonary Vascular Engorgement in Normal Subjects 1

Cited by 80 publications

References 13 publications

The Effect of Pulmonary Vascular Pressures on the Mechanical Properties of the Lungs of Anesthetized Dogs1

The Effect of Pulmonary Vascular Pressures on the Mechanical Properties of the Lungs of Anesthetized Dogs1

The Effect of Changes in the Pulmonary Vascular Bed Produced by Atropine, Pulmonary Engorgement, and Positive-Pressure Breathing on Diffusing and Mechanical Properties of the Lung*

Some Effects of Restriction of Chest Cage Expansion on Pulmonary Function in Man: An Experimental Study*†

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