Pulmonary shunt is independent of decrease in cardiac output during unsupported spontaneous breathing in the pig

Anesthesiology

Volumn 118, Issue 4, 2013, Pages 914-923

  Vimlati, Laszlo ^a,b   Larsson, Anders ^a   Hedenstierna, Goran ^a   Lichtwarck Aschoff, Michael ^a  

^a UPPSALA UNIVERSITY   (Sweden)

^b Uppsala Cancer Clinic   (Sweden)

Author keywords

[No Author keywords available]

Indexed keywords

WATER;

ANIMAL EXPERIMENT; ANIMAL MODEL; ARTICLE; ARTIFICIAL VENTILATION; BALLOON OCCLUSION; BREATHING; BREATHING RATE; CONTROLLED STUDY; CORRELATION COEFFICIENT; HEART OUTPUT; HYPOXIC LUNG VASOCONSTRICTION; INFERIOR CAVA VEIN; LUNG BLOOD FLOW; NONHUMAN; OXYGEN SATURATION; PIGLET; POSITIVE END EXPIRATORY PRESSURE; PRIORITY JOURNAL; PULMONARY SHUNT; SWINE; TIDAL VOLUME; VENOUS OXYGEN TENSION; VENOUS RETURN;

ANIMALS; BALLOON OCCLUSION; BRONCHI; CARBON DIOXIDE; CARDIAC OUTPUT; CONTINUOUS POSITIVE AIRWAY PRESSURE; LUNG; RESPIRATION; RESPIRATION, ARTIFICIAL; SWINE; TIDAL VOLUME; VENA CAVA, INFERIOR;

EID: 84875898136     PISSN: 00033022     EISSN: 15281175     Source Type: Journal    
DOI: 10.1097/ALN.0b013e318283c81f     Document Type: Article

References (40)

1. Putensen C, Mutz NJ, Putensen-Himmer G, Zinserling J: Spontaneous breathing during ventilatory support improves ventilation-perfusion distributions in patients with acute respiratory distress syndrome. Am J Respir Crit Care Med 1999; 159(4 Pt 1):1241-8
2. Wrigge H, Zinserling J, Neumann P, Defosse J, Magnusson A, Putensen C, Hedenstierna G: Spontaneous breathing improves lung aeration in oleic acid-induced lung injury. Anesthesiology 2003; 99:376-84
3. Neumann P, Wrigge H, Zinserling J, Hinz J, Maripuu E, Andersson LG, Putensen C, Hedenstierna G: Spontaneous breathing affects the spatial ventilation and perfusion distribution during mechanical ventilatory support. Crit Care Med 2005; 33:1090-5
4. Carvalho AR, Spieth PM, Pelosi P, Beda A, Lopes AJ, Neykova B, Heller AR, Koch T, Gama de Abreu M: Pressure support ventilation and biphasic positive airway pressure improve oxygenation by redistribution of pulmonary blood flow. Anesth Analg 2009; 109:856-65
5. Vimlati L, Kawati R, Hedenstierna G, Larsson A, Lichtwarck-Aschoff M: Spontaneous breathing improves shunt fraction and oxygenation in comparison with controlled ventilation at a similar amount of lung collapse. Anesth Analg 2011; 113:1089-95
6. Domino KB, Wetstein L, Glasser SA, Lindgren L, Marshall C, Harken A, Marshall BE: Influence of mixed venous oxygen tension (PVO2) on blood flow to atelectatic lung. Anesthesiology 1983; 59:428-34
7. Marshall BE, Marshall C, Frasch F, Hanson CW: Role of hypoxic pulmonary vasoconstriction in pulmonary gas exchange and blood flow distribution. 1. Physiologic concepts. Intensive Care Med 1994; 20:291-7
8. Marshall BE, Hanson CW, Frasch F, Marshall C: Role of hypoxic pulmonary vasoconstriction in pulmonary gas exchange and blood flow distribution. 2. Pathophysiology. Intensive Care Med 1994; 20:379-89
9. Benumof JL, Wahrenbrock EA: Blunted hypoxic pulmonary vasoconstriction by increased lung vascular pressures. J Appl Physiol 1975; 38:846-50
10. Vimláti L, Larsson A, Hedenstierna G, Lichtwarck-Aschoff M: Haemodynamic stability and pulmonary shunt during spontaneous breathing and mechanical ventilation in porcine lung collapse. Acta Anaesthesiol Scand 2012; 56:748-54
11. Berggren S: The oxygen deficit of arterial blood caused by nonventilating parts of the lung. Acta Physiol Scand 1942;4:1-92
12. Smith G, Cheney FW Jr, Winter PM: The effect of change in cardiac output on intrapulmonary shunting. Br J Anaesth 1974; 46:337-42
13. Arndt GA, Kranner PW, Rusy DA, Love R: Single-lung ventilation in a critically ill patient using a fiberoptically directed wire-guided endobronchial blocker. Anesthesiology 1999; 90:1484-6
14. Edwards LJ: Modern statistical techniques for the analysis of longitudinal data in biomedical research. Pediatr Pulmonol 2000; 30:330-44
15. West B, Welch KB, Galecki AT: Linear mixed models: An overview, in Linear Mixed Models: A Practical Guide Using Statistical Software, ed 1. Boca Raton, Chapman & Hall/CRC, 2007, pp 9-49
16. West B, Welch KB, Galecki AT: Models for repeated measures data: The rat brain example, in Linear Mixed Models: A Practical Guide Using Statistical Software, ed 1. Boca Raton, Chapman & Hall/CRC, 2007, pp 175-218
17. Lynch JP, Mhyre JG, Dantzker DR: Influence of cardiac output on intrapulmonary shunt. J Appl Physiol 1979; 46: 315-21
18. Peake MD, Harabin AL, Brennan NJ, Sylvester JT: Steady-state vascular responses to graded hypoxia in isolated lungs of five species. J Appl Physiol 1981; 51:1214-9
19. Dantzker DR, Lynch JP, Weg JG: Depression of cardiac output is a mechanism of shunt reduction in the therapy of acute respiratory failure. Chest 1980; 77:636-42
20. Fredén F, Cigarini I, Mannting F, Hagberg A, Lemaire F, Hedenstierna G: Dependence of shunt on cardiac output in unilobar oleic acid edema: Distribution of ventilation and perfusion. Intensive Care Med 1993; 19:185-90
21. Russell WJ, James MF: The effects on increasing cardiac output with adrenaline or isoprenaline on arterial haemoglobin oxygen saturation and shunt during one-lung ventilation. Anaesth Intensive Care 2000; 28:636-41
22. Sandoval J, Long GR, Skoog C, Wood LD, Oppenheimer L: Independent influence of blood flow rate and mixed venous PO2 on shunt fraction. J Appl Physiol 1983; 55:1128-33
23. Bishop MJ, Cheney FW: Effects of pulmonary blood flow and mixed venous O2 tension on gas exchange in dogs. Anesthesiology 1983; 58:130-5
24. Grasso F, Engelberts D, Helm E, Frndova H, Jarvis S, Talakoub O, McKerlie C, Babyn P, Post M, Kavanagh BP: Negativepressure ventilation: Better oxygenation and less lung injury. Am J Respir Crit Care Med 2008; 177:412-8
25. Raymondos K, Molitoris U, Capewell M, Sander B, Dieck T, Ahrens J, Weilbach C, Knitsch W, Corrado A: Negativeversus positive-pressure ventilation in intubated patients with acute respiratory distress syndrome. Crit Care 2012; 16:R37
26. Sylvester JT, Mitzner W, Ngeow Y, Permutt S: Hypoxic constriction of alveolar and extra-alveolar vessels in isolated pig lungs. J Appl Physiol 1983; 54:1660-6
27. Radke OC, Schneider T, Heller AR, Koch T: Spontaneous breathing during general anesthesia prevents the ventral redistribution of ventilation as detected by electrical impedance tomography: A randomized trial. Anesthesiology 2012; 116:1227-34
28. Hsu JY, Chen WT, Kao CC, Lee SJ, Chang H: Ventilationperfusion distribution and shunt fraction during one-lung ventilation: Effect of different inhaled oxygen levels. Chin J Physiol 2008; 51:48-53
29. Hankins GD, Harvey CJ, Clark SL, Uckan EM, Van Hook JW: The effects of maternal position and cardiac output on intrapulmonary shunt in normal third-trimester pregnancy. Obstet Gynecol 1996; 88:327-30
30. Stickland MK, Lovering AT, Eldridge MW: Exercise-induced arteriovenous intrapulmonary shunting in dogs. Am J Respir Crit Care Med 2007; 176:300-5
31. Eldridge MW, Dempsey JA, Haverkamp HC, Lovering AT, Hokanson JS: Exercise-induced intrapulmonary arteriovenous shunting in healthy humans. J Appl Physiol 2004; 97:797-805
32. Vogiatzis I, Zakynthinos S, Boushel R, Athanasopoulos D, Guenette JA, Wagner H, Roussos C, Wagner PD: The contribution of intrapulmonary shunts to the alveolar-to-arterial oxygen difference during exercise is very small. J Physiol (Lond) 2008; 586:2381-91
33. Lumb A: Peripheral input to the respiratory centre and nonchemical reflexes, in Nunn's Applied Respiratory Physiology, ed 6th. Philadelphia, Elsevier/Butterworth-Heinemann, 2005, pp 59-61
34. Gibbs JM, Johnson H: Lack of effect of morphine and buprenorphine on hypoxic pulmonary vasoconstriction in the isolated perfused cat lung and the perfused lobe of the dog lung. Br J Anaesth 1978; 50:1197-201
35. Bjertnaes LJ: Hypoxia-induced vasoconstriction in isolated perfused lungs exposed to injectable or inhalation anesthetics. Acta Anaesthesiol Scand 1977; 21:133-47
36. Busch CJ, Spöhr FA, Motsch J, Gebhard MM, Martin EO, Weimann J: Effects of ketamine on hypoxic pulmonary vasoconstriction in the isolated perfused lungs of endotoxaemic mice. Eur J Anaesthesiol 2010; 27:61-6
37. Bellezza M, Kerbaul F, Roussel L, Imbert M, Guidon C: The effect of hypertonic saline dextran solutions on hypoxic pulmonary vasoconstriction in anaesthetised piglets. Eur Respir J 2002; 20:965-71
38. Ketabchi F, Egemnazarov B, Schermuly RT, Ghofrani HA, Seeger W, Grimminger F, Shid-Moosavi M, Dehghani GA, Weissmann N, Sommer N: Effects of hypercapnia with and without acidosis on hypoxic pulmonary vasoconstriction. Am J Physiol Lung Cell Mol Physiol 2009; 297:L977-83
39. Brimioulle S, Lejeune P, Vachiery JL, Leeman M, Melot C, Naeije R: Effects of acidosis and alkalosis on hypoxic pulmonary vasoconstriction in dogs. Am J Physiol 1990; 258(2 Pt 2):H347-53
40. Nilsson MC, Fredén F, Larsson A, Wiklund P, Bergquist M, Hambraeus-Jonzon K: Hypercapnic acidosis transiently weakens hypoxic pulmonary vasoconstriction without affecting endogenous pulmonary nitric oxide production. Intensive Care Med 2012; 38:509-17