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Anesth Analg 1988; 67:763-769
© 1988 International Anesthesia Research Society
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The Effect of Pleural Pressure on the Hypoxic Pulmonary Vasoconstrictor Response in Closed Chest Dogs

Linda Chen, MD, Jay James Williams, MD, PhD, Christian M. Alexander, MD, Roberta J. Ray, MB, ChB, Carol Marshall, PhD, and Bryan E. Marshall, MD, FRCP

Received from the McNeil Center for Research in Anesthesia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.

Abstract

The effect of intrapleural pressure on the hypoxic pulmonary vasoconstrictor (HPV) responses to atelectasis and hypoxia were measured in two groups of anesthetized closed chest dogs. The right lung was continuously ventilated with 100% O2. The left lung was initially ventilated with 100% O2, (hyperoxia) but subsequently underwent either reabsorption atelectasis (atelectasis; group I) or ventilation with a hypoxic gas mixture (hypoxia; group II). The mean intrapleural pressure in the left hemithorax was 5.4 cm H2O during hyperoxia, but with left lung atelectasis decreased significantly to –3.8 cm H2O by 15 minutes and to –4.2 cm H2O by 90 minutes. Venous admixture (%VA) increased significantly from 10.3% during hyperoxia to 33.2% at 15 minutes of left lung atelectasis and to 34.6% at 90 minutes. However, after sternotomy with the left lung still atelectatic, the %VA decreased significantly to 25.4%. For the hypoxia group, %VA increased significantly from 9.2% during hyperoxia to 29.9% at 15 minutes of left lung hypoxia and 25.1 % at 90 minutes. HPV diverted blood flow away from both atelectatic lung and hypoxic lung. However, due to the negative intrapleural pressure generated during left lung resorption atelectasis when the chest was closed, HPV was less effective during atelectasis than during hypoxia.

Key Words: LUNG, ATELECTASIS—hypoxic pulmonary vasoconstriction • HYPOXIA—pulmonary vasoconstriction
Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins and Stanford University Libraries' HighWire Press®. Copyright 1988 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1988 by the International Anesthesia Research Society.