Journal of Applied Physiology
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J Appl Physiol 81: 1664-1669, 1996;
8750-7587/96 $5.00
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Journal of Applied Physiology
Vol. 81, No. 4, pp. 1664-1669, October 1996
SYSTEMIC CIRCULATION AND FLUID BALANCE

Changes in bronchial and pulmonary arterial blood flow with progressive tension pneumothorax

Paula Carvalho, Jacob Hildebrandt, and Nirmal B. Charan

Pulmonary Research Laboratory, Department of Veterans Affairs Medical Center, Boise, Idaho 83702; and Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Washington, Seattle, Washington 98195

Received 1 December 1995; accepted in final form 7 May 1996.

Carvalho, Paula, Jacob Hildebrandt, and Nirmal B. Charan. Changes in bronchial and pulmonary arterial blood flow with progressive tension pneumothorax. J. Appl. Physiol. 81(4): 1664-1669, 1996.---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.

vascular conductance; pleural pressure; gas exchange; respiratory compliance




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