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1 Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
* To whom correspondence should be addressed. E-mail: Connie.Hsia{at}utsouthwestern.edu.
Airway lengthening after pneumonectomy (PNX) may increase diffusive resistance to gas mixing (1/DG); the effect is accentuated by increasing acinar gas density but is difficult to detect from carbon monoxide diffusing capacity (DLCO). Since nitric oxide diffusing capacity (DLNO) is 3-5 fold that of DLCO, whereas 1/DG for NO and CO are similar, we hypothesized that a density dependent fractional reduction would be greater for DLNO than DLCO. We measured DLNO and DLCO at 2 tidal volumes (VT) and 3 background gases: helium (He), nitrogen (N2) and sulfur hexafluoride (SF6), in immature dogs 3 and 9 mo following right PNX (5 and 11 mo of age). At maturity (11 mo), background gas density had no effect on <DLNO, DLCO or DLNO/DLCO in SHAM controls. In PNX animals, <DLNO declined 25-50% in SF6 relative to He and N2, and DLNO/DLCO declined ~50% in SF6 relative to He at VT=15 ml/kg, consistent with a significant 1/DG. At 5 mo of age, DLNO/DLCO declined 25-45% in SF6 relative to He and N2 in both groups, but DLCO increased paradoxically in SF6 relative to N2 or He by 20-60%. Findings suggest that SF6, besides increasing 1/DG, may redistribute ventilation and/or enhance acinar penetration of the convective front.
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