Pulmonary compliance in patients with cardiac disease

Frank, N. R.; Lyons, Harold A.; Siebens, Arthur A.; Nealon, Thomas F.

doi:10.1016/0002-9343(57)90106-7

Cited by 67 publications

(28 citation statements)

References 13 publications

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“…forced oscillations; alveolar wall; elastin; end-expiratory lung volume THE MECHANICAL PROPERTIES of the lungs are significantly influenced by changes in the pulmonary hemodynamic conditions (3,7,9,11,20,21, 27,29,(35)(36)(37)40). Numerous clinical (3,7,9,11,20, 27) and experimental studies (29,36,37) have demonstrated that elevation of the pulmonary blood flow (7,20, 27) and/or pressure (3, 11, 29, 36, 37) leads to a deterioration of the lung function via a decrease in functional residual capacity (FRC) (7) and/or stiffening of the alveolar wall (40). Although the qualitative examinations performed by von Basch (38a) in 1889 suggested that not only congestion, but also pulmonary hypoperfusion, can alter the lung configuration, few data are available concerning the changes in the mechanical conditions of the lungs during hypoperfusion or the complete absence of pulmonary perfusion (21,25,29,35).…”

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confidence: 99%

Impact of microvascular circulation on peripheral lung stability

Peták

Babik

Hantos

et al. 2004

American Journal of Physiology-Lung Cellular and Molecular Phys

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volvement of pulmonary circulation in the mechanical properties was studied in isolated rat lungs. Pulmonary input impedance (ZL) was measured at a mean transpulmonary pressure (Ptp mean) of 2 cmH2O before and after physiological perfusion with either blood or albumin. In these lungs and in a group of unperfused lungs, ZL was also measured at Ptp mean values between 1 and 8 cmH2O. Airway resistance (R aw) and parenchymal damping (G) and elastance (H) were estimated from ZL. End-expiratory lung volume (EELV) was measured by immersion before and after blood perfusion. The orientation of the elastin fibers relative to the basal membrane was assessed in additional unperfused and blood-perfused lungs. Pressurization of the pulmonary capillaries significantly decreased H by 31.5 Ϯ 3.7% and 18.7 Ϯ 2.7% for blood and albumin, respectively. Perfusion had no effect on R aw but markedly altered the Ptpmean dependences of G and H Ͻ4 cmH 2O, with significantly lower values than in the unperfused lungs. At a Ptp mean of 2 cmH2O, EELV increased by 31 Ϯ 11% (P ϭ 0.01) following pressurization of the capillaries, and the elastin fibers became more parallel to the basal membrane. Because the organization of elastin fibers results in smaller H values of the individual alveolus, the higher H in the unperfused lungs is probably due to a partial alveolar collapse leading to a loss in lung volume. We conclude that the physiological pressure in the pulmonary capillaries is an important mechanical factor in the maintenance of the stability of the alveolar architecture. forced oscillations; alveolar wall; elastin; end-expiratory lung volume THE MECHANICAL PROPERTIES of the lungs are significantly influenced by changes in the pulmonary hemodynamic conditions (3,7,9,11,20,21, 27,29,(35)(36)(37)40). Numerous clinical (3,7,9,11,20, 27) and experimental studies (29,36,37) have demonstrated that elevation of the pulmonary blood flow (7,20, 27) and/or pressure (3, 11, 29, 36, 37) leads to a deterioration of the lung function via a decrease in functional residual capacity (FRC) (7) and/or stiffening of the alveolar wall (40). Although the qualitative examinations performed by von Basch (38a) in 1889 suggested that not only congestion, but also pulmonary hypoperfusion, can alter the lung configuration, few data are available concerning the changes in the mechanical conditions of the lungs during hypoperfusion or the complete absence of pulmonary perfusion (21,25,29,35). Mitzner et al. (25) observed a transient increase in the respiratory resistance and a decrease in the compliance after occluding a pulmonary artery in mice, but the explanation of this finding remained unclarified. Furthermore, we recently demonstrated that low pulmonary venous pressures cause an impairment in lung mechanics, manifested in increases in the parenchymal resistive and elastic parameters, while the airway properties remain unaffected (29). However, the mechanisms responsible for the compromised lung mechanics at low vascular pressure or when there is no perfusion ...

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confidence: 99%

Impact of microvascular circulation on peripheral lung stability

Peták

Babik

Hantos

et al. 2004

American Journal of Physiology-Lung Cellular and Molecular Phys

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“…A compromised lung function has been observed in clinical situations involving an abnormally high pulmonary blood flow (Q p ) (9,11,13,22,24) and/or an elevated pulmonary arterial pressure (Ppa) (1-3, 5, 6, 20, 23, 26-28). Nevertheless, the results of these previous studies lead to inconsistent conclusions as to which of the pulmonary hemodynamic parameters has the dominant effect on lung mechanics.…”

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confidence: 99%

Effects of pulmonary vascular pressures and flow on airway and parenchymal mechanics in isolated rat lungs

Peták

Habre

Hantos

et al. 2002

Journal of Applied Physiology

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Changes in pulmonary hemodynamics have been shown to alter the mechanical properties of the lungs, but the exact mechanisms are not clear. We therefore investigated the effects of alterations in pulmonary vascular pressure and flow (Q p) on the mechanical properties of the airways and the parenchyma by varying these parameters independently in three groups of isolated perfused normal rat lungs. The pulmonary capillary pressure (Pcest), estimated from the pulmonary arterial (Ppa) and left atrial pressure (Pla), was increased at constant Q p (n ϭ 7), or Q p was changed at Pcest ϭ 10 mmHg (n ϭ 7) and at Pcest ϭ 20 mmHg (n ϭ 6). In each condition, the airway resistance (Raw) and parenchymal damping (G) and elastance (H) were identified from the low-frequency pulmonary input impedance spectra. The results of measurements made under isogravimetric conditions were analyzed. The changes observed in the mechanical parameters were consistent with an altered Pla: monotonous increases in Raw were observed with increasing Pla, whereas G and H were minimal at Pla of ϳ7-10 mmHg and increased at lower and higher Pla. The results indicate that Pla, and not Ppa or Q p, is the primary determinant of the mechanical condition of the lungs after acute changes in pulmonary hemodynamics: the parenchymal mechanics are impaired if Pla is lower or higher than physiological, whereas airway narrowing occurs at high Pla. respiratory mechanics; forced oscillations; pulmonary circulation

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“…Frank et al 4 and Cherniack and Brown20 found a significant correlation between TLC and pulmonary compliance. We did not demonstrate this, but found RV/TLC per cent of predicted to have a high degree of association with compliance (r = -o.603, P<0.02).…”

Section: Discussionmentioning

confidence: 94%

The Effects of Anesthesia and Cardiac Bypass on Pulmonary Compliance in Man

Hand

Malm

Bowman

et al. 1971

Survey of Anesthesiology

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p ULMONARY compliance has been shown to be decreased for a period of several weeks following anesthesia and open-heart operations." 2 This postoperative decrease in compliance is a further change from the low preoperative values seen in patients with heart disease and pulmonary hypertension.34 The prolonged postoperative decrease in pulmonary compliance has not been correlated with changes in lung volumes or in pulmonary gas exchange. The purpose of this study is to relate changes in compliance to other pulmonary functions in the postcardiotomy patient an an attempt to simplify the study of pulmonary function in patients who undergo operations on the heart. METHODSPatients with mitral stenosis were studied before and after cardiac bypass. The subjects were studied in the supine position on four occasions: preoperatively, I to 2 days prior to operation; in the recovery room immediately after operation while breathing continued spon-*Presented at a meeting

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Pulmonary compliance in patients with cardiac disease

Cited by 67 publications

References 13 publications

Impact of microvascular circulation on peripheral lung stability

Impact of microvascular circulation on peripheral lung stability

Effects of pulmonary vascular pressures and flow on airway and parenchymal mechanics in isolated rat lungs

The Effects of Anesthesia and Cardiac Bypass on Pulmonary Compliance in Man

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