Changes in bronchial and pulmonary arterial blood flow with progressive tension pneumothorax.
We studied the effects of unilateral tension pneumothorax and its release on bronchial and pulmonary arterial blood flow and gas exchange in 10 adult anesthetized and mechanically ventilated sheep with chronically implanted ultrasonic flow probes. Right pleural pressure (Ppl) was increased in two steps from -5 to 10 and 25 cmH2O and then decreased to 10 and -5 cmH2O. Each level of Ppl was maintained for 5 min. Bronchial blood flow, right and left pulmonary arterial flows, cardiac output (QT), hemodynamic measurements, and arterial blood gases were obtained at the end of each period. Pneumothorax resulted in a 66% decrease in QT, bronchial blood flow decreased by 84%, and right pulmonary arterial flow decreased by 80% at Ppl of 25 cmH2O (P < 0.001). At peak Ppl, the majority of QT was due to blood flow through the left pulmonary artery. With resolution of pneumothorax, hemodynamic parameters normalized, although abnormalities in gas exchange persisted for 60-90 min after recovery and were associated with a decrease in total respiratory compliance.
Pulmonary Research Laboratory, Department of Veterans Affairs Medical Center, Boise, Idaho 83702, USA.
P
P
Carvalho
J
J
Hilderbrandt
N B
NB
Charan
D000818:Animals; D001784:Blood Gas Analysis; D001794:Blood Pressure / Q000502:physiology; D001980:Bronchi / Q000098:blood supply / Q000000981:diagnostic imaging; D001981:Bronchial Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002302:Cardiac Output / Q000502:physiology; D005540:Forced Expiratory Flow Rates; D006863:Hydrogen-Ion Concentration; D008170:Lung Compliance / Q000502:physiology; D010994:Pleura / Q000098:blood supply; D011030:Pneumothorax / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011652:Pulmonary Circulation / Q000502:physiology*; D011659:Pulmonary Gas Exchange / Q000502:physiology; D012039:Regional Blood Flow / Q000502:physiology; D012756:Sheep; D014463:Ultrasonography; D014655:Vascular Resistance / Q000502:physiology