Pulmonary Perfusion Changes After Experimental Unilateral Bronchial Occlusion and Their Clinical Implications

Isawa, Toyoharu; Benfield, John R.; Johnson, Donald J.; Taplin, George V.

doi:10.1148/99.2.355

Cited by 36 publications

(9 citation statements)

References 2 publications

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“…1966). Besides regionally increased alveolar pressure as a cause of decreased perfusion distribution as shown in this paper , regional hypoventilation due to bronchial occlusion, hypoxia and hypercarbia have been known to induce regional decrease in perfusion distribution (Isawa et al 1967(Isawa et al , 1971(Isawa et al , 1977Fishman 1976). In bronchial asthma, however, Henderson and others think that regional hypoxia due to bronchospasm and mucus plugging plays a more important role than increased alveolar pressure does in reducing regional perfusion distribution (Henderson et al 1967).…”

Section: Discussionmentioning

confidence: 76%

Regulation of Regional Perfusion Distribution in the Lungs. Experimental Model and Effect of Alveolar Pressure

Isawa

Teshima

Hirano

et al. 1978

Tohoku J. Exp. Med.

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Section: Discussionmentioning

confidence: 76%

Regulation of Regional Perfusion Distribution in the Lungs. Experimental Model and Effect of Alveolar Pressure

Isawa

Teshima

Hirano

et al. 1978

Tohoku J. Exp. Med.

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“…They related this finding to their previous finding by bronchial occlusion of the 02 filled lung and have concluded that hypoxia is the main cause of the reduction in flow but that hypercapania may play an additional part (Barer et al 1969). In bronchial occlusion, regional perfu sion was very rapidly reduced and hypoxia was assumed to play the major role in the reduction of blood flow (Isawa et al 1971b). Grant and associates demonstrated in coatimundi that there was a 22% reduction in local perfusion (as percent of flow at PAO2 of 100 mmHg) per 100 mm Hg fall in local alveolar 02 tension over the PAO2 range between 150 and 36 mmHg, but they stated that local hypercapnia has little effect on local flow (Grant et al 1976).…”

Section: Discussionmentioning

confidence: 99%

“…Our present findings indicate that alveolar hypercapnia modifies regional vascular responses to an extreme alveolar hyperoxia, but otherwise the concurrent alveolar hypercapnia has little effect on regional perfusion. The presence of regional hypoxic and hyperoxic vasoconstric tion and vaosdilation and/or recruitment, respectively, seems to be a universal phenomenon and has been demonstrated even under alveolar hyperinflation due to the increased alveolar pressure (Isawa et al 1978a), and no nervous =integrity seems to be required for these phenomena to occur (Isawa et al 1971b(Isawa et al , 1978b. These hypoxic and hyperoxic pulmonary vascular changes seem to occur locally in the lung parenchyma with little or no nervous mediation.…”

Section: Discussionmentioning

confidence: 99%

Effect of alveolar hypercapnia on regional pulmonary perfusion.

Isawa

Teshima

Hirano

et al. 1980

Tohoku J. Exp. Med.

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The effect of alveolar hypercapnia under a wide range of alveolar oxygen tensions was assessed in the right upper lobe of the normal dogs and the dogs with the reimplanted right lung. To induce alveolar hypercapnia by artificial ventilation of the right upper lobe, gas mixtures of differing oxygen fractions containing 10% or 20% CO, were used as exchange gases for the right upper lobe. The concurrent alveolar hypercapnia had little superimposed effect on the regional vascular responses to a wide range of alveolar oxygen tensions in the normal and the reimplanted denervated lung lobe. Under an extreme alveolar hyperoxia, however, the concurrent alveolar hypercapnia somewhat suppressed regional hyperoxic vasodila tion and/or recruitment of the pulmonary vascular beds, whereas in the reimplanted lung lobe it potentiated the hyperoxic pulmonary vascular response. The alveolar oxygen tension seems to be the main factor in the regulation of regional perfusion in the lungs. alveolar hypercapnia; denervated lung; hypoxic vasoconstriction; hyperoxic vasodilation and/or recruitment; "O2 sensing device"

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“…22,23 In fact postoperatively regional ventilation can often be adversely affected by mucous accumulation in the airways. 14 Any mucous deposits on the airways are imaged as "hot spots" by aerosol inhalation lung imaging and these "hot spots" mostly occurred in the operated lung.…”

Section: Discussionmentioning

confidence: 99%

Incidence of pulmonary embolism in a chest hospital in Japan and importance of preoperative perfusion lung imaging in the diagnosis of postoperative pulmonary embolism

et al. 1991

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The incidence of pulmonary embolism was retrospectively studied in a University Chest Institute and its affiliated hospital in Sendai, Japan, whose annual numbers of discharged patients from chest medical wards and lung operations as a whole are about 600 and 400, respectively. Before 1975 there was no documented patient with pulmonary embolism. Since then 70 patients had been clinically suspected of having pulmonary embolism and 31 of the 70 were diagnosed as having pulmonary embolism; 15 without and 16 with surgical operations in the immediate past. Fourteen of the 31 patients required combined perfusion and aerosol inhalation lung imaging for diagnosis. Twelve postoperative patients could be diagnosed as pulmonary embolism by comparing postoperative perfusion lung images taken at the time of suspicion with preoperative perfusion counterparts. Although it is said to be rising, the incidence of pulmonary embolism in a chest hospital still seems to remain low compared with that in western countries. For postoperative patients, comparison with preoperative studies was found very useful in diagnosing postoperative pulmonary embolism. The importance of preoperative perfusion lung imaging cannot be overstressed not only as a preoperative lung function test but as a baseline study to be compared with postoperative perfusion images when pulmonary embolism is clinically suspected in postoperative patients.

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Pulmonary Perfusion Changes After Experimental Unilateral Bronchial Occlusion and Their Clinical Implications

Cited by 36 publications

References 2 publications

Regulation of Regional Perfusion Distribution in the Lungs. Experimental Model and Effect of Alveolar Pressure

Regulation of Regional Perfusion Distribution in the Lungs. Experimental Model and Effect of Alveolar Pressure

Effect of alveolar hypercapnia on regional pulmonary perfusion.

Incidence of pulmonary embolism in a chest hospital in Japan and importance of preoperative perfusion lung imaging in the diagnosis of postoperative pulmonary embolism

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