We have developed a minimally invasive technique for studying regional blood flow in conscious sheep, bypassing the complications of open-chest surgery, flow probes and tracer infusion. We quantitate regional perfusion continuously on the basis of regional clearance of methane (methane is produced in the sheep rumen, enters the circulation and is eliminated nearly completely (greater than 95%) in the lung). Tracheal intubation with a dual-lumen catheter isolates the gas exchange of the right apical lobe (RAL; less than 15% of the lung) from that of the remainder of the lung, which serves as a control (CL). We measure RAL and CL methane elimination by entraining expirates in constant flows, sampled continuously for methane. Results obtained with this technique and from regional oxygen uptake are in excellent agreement. We have found that hypoxic vasoconstriction is far more potent and stable during eucapnic hypoxia than during hypocapnic hypoxia. The time course of the vasoconstriction suggests that many of the data in the literature may have been obtained prior to steady state.
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http://dx.doi.org/10.1016/0034-5687(92)90017-q | DOI Listing |
Front Surg
December 2024
Department of Anesthesiology, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, Fujian, China.
Background: Single-lung ventilation (SLV) is a widely used procedure in thoracic surgery; however, it can lead to hypoxemia, which is attributed to intrapulmonary shunt and hypoxic pulmonary vasoconstriction. Stellate ganglion blockade (SGB) has shown protective effects during SLV in various pulmonary conditions. The objective of the study was to assess the clinical utility of ultrasound-guided SGB in patients undergoing thoracoscopic pulmonary lobectomy through a prospective clinical trial.
View Article and Find Full Text PDFOpen Heart
January 2025
Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
Background: Hypoxic pulmonary vasoconstriction leads to an increase in pulmonary artery pressure (PAP) and potentially right heart failure in healthy individuals and patients with respiratory diseases. Previous studies in patients with chronic obstructive pulmonary disease (COPD) exposed to hypobaric hypoxia have shown an increase in PAP, while traditional echocardiographic parameters revealed only minimal changes at high altitude. Speckle-tracking-derived analysis is potentially more sensitive to assess right ventricular (RV) function and we used this method to investigate the impact on RV function of patients with COPD ascending to high altitude and compared the results with the traditional echocardiographic parameters.
View Article and Find Full Text PDFJACC Case Rep
December 2024
Department of Internal Medicine, University of California-San Francisco School of Medicine, San Francisco, California, USA.
J Clin Med
December 2024
Department of Obstetrics and Gynecology, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain.
J Clin Monit Comput
December 2024
Pediatric perioperative medicine and Intensive Care, Karolinska University Hospital, Eugeniavägen 23, Stockholm, 171 64, Sweden.
Purpose: The capnodynamic method, End Expiratory Lung Volume CO (EELV-CO), utilizes exhaled carbon dioxide analysis to estimate End-Expiratory Lung Volume (EELV) and has been validated in both normal lungs and lung injury models. Its performance under systemic hypoxia and variations in CO elimination is not examined. This study aims to validate EELV-CO against inert gas wash in/wash out (EELV- SF6, sulfur hexafluoride) in a porcine model of stable hemodynamic conditions followed by hypoxic pulmonary vasoconstriction and inhaled nitric oxide (iNO).
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