Micropuncture pressure in small arteries or veins of perfused rabbit lungs

Until now, direct micropuncture measurements of vascular pressure in lung have been limited to small vessels less than 100 microns on the pleural surface. On the other hand, direct pressure measurements using small catheters (less than 1-mm OD) in pulmonary vessels have been limited to those greater than 1.2 mm. We measured pressure in intermediate-sized microvessels (300-700 microns) using the micropuncture method in isolated perfused rabbit lungs. These microvessels are located 2 or 3 mm beneath the pleura. We exposed them by microsurgery and punctured the relatively thick-walled vessels with specially configured micropipettes. We exposed one pulmonary microvessel in each rabbit lung by microsurgery on the left middle lobe. In 15 rabbit lungs we measured pressure in a total of six small arteries (275- to 470-microns diam) and nine small veins (300- to 700-microns diam) under high zone 3 conditions, near the zone 2/3 boundary. We found approximately 35% of the total pulmonary vascular pressure drop in arteries greater than 275-microns diam and 7% in veins greater than 300-microns diam. In veins greater than 500-microns diam, there was no measurable pressure drop. After the measurements, we froze the lung and confirmed that there was no detectable interstitial or alveolar edema in the cross sections of the punctured site. Our data are compatible with those of other investigators who have used isolated perfused rabbit lungs under similar experimental conditions.

Erythrocytes reduce liquid filtration in injured dog lungs

In isolated, dog lung lobes with pulmonary vessels filled with different liquids, we measured the rate of weight gain for 5 or 10 min at constant alveolar and vascular pressures under zone 1 conditions (alveolar pressure greater than vascular pressure). We used six different liquids: syngeneic plasma, whole blood (hematocrit = 38 +/- 4%), 4% albumin in Krebs-Ringer solution, washed red blood cells in Krebs-Ringer solution (hematocrit = 37 +/- 6%), and platelet-rich or platelet-poor plasma. We studied the lobes under three conditions: immediate perfusion after removal (less than 30 min), delayed perfusion (2 h or more), or immediate perfusion after removal from air-embolized animals. In lobes that showed low-filtration rate using plasma [less than 0.5 g/(min x 100 g)] substitution of whole blood had no effect on the filtration rate. In lobes that showed high-filtration rates using plasma (delayed perfusion or deliberately injured using air emboli) substitution of whole blood caused a dramatic decrease in the filtration rate, restoring it to the level obtained in uninjured lobes. Platelets had no effect. Thus the red cells specifically reduced abnormally high filtration but did not affect normal filtration. There appear to be three possible mechanisms: 1) red cells physically blocking large leaks; 2) red cells settling on the filtration surface area (osmotic-barrier effect); 3) red cells acting as reducing agents against active oxygen metabolites.(ABSTRACT TRUNCATED AT 250 WORDS)

Indirect estimate of perimicrovascular pressure rise in edema in isolated zone 1 lung

To determine how liquid accumulation affects extra-alveolar perimicrovascular interstitial pressure, we measured filtration rate under zone 1 conditions (25 cmH2O alveolar pressure, 20 or 10 cmH2O vascular pressure) in isolated dog lung lobes in which all vessels were filled with autologous plasma. In the base-line condition, starting with normal extra-alveolar water content, filtration rate decreased by about one-half over 1 h as edema liquid slowly accumulated. We repeated each experiment after inducing edema (up to 100% lung weight gain). The absolute values and time course of filtration in the edema condition did not differ from base-line, i.e., the edema did not affect the time course of filtration. To compute the maximal initial and maximal change in extra-alveolar perimicrovascular pressure that occurred over each 1-h filtration study, we first assumed that the reflection coefficient is 0 in the Starling equation, then calculated perimicrovascular pressure and filtration coefficient from two equations with two unknowns. The mean filtration coefficient in 10 lobes is 0.063 g/(min X cmH2O X 100 g wet wt), and the initial perimicrovascular pressure is 3.9 cmH2O, rising by 4-7 cmH2O at 1 h. Finally we tested low protein perfusates and found the filtration rate was higher. We calculated an overall reflection coefficient = 0.44, a decrease in the initial perimicrovascular pressure to 1.9 cmH2O and a slightly lower increase after 1 h of edema formation, 2.2-6.6 cmH2O.

No gravity-independent gradient of blood flow distribution in dog lung

The existence of a major gravity-independent gradient of blood flow in lungs has recently been described based on single photon emission computed tomography after intravenous injection of radioactively labeled macroaggregates. We wanted to test this hypothesis of a major gravity-independent gradient in lung blood flow in experiments with direct measurement of macroaggregate distribution in the dog lung. In six anesthetized (4 prone spontaneously breathing, 2 mechanically ventilated) dogs we injected 111In-labeled albumin macroaggregates intravenously. We killed the dogs, removed, inflated, and froze the lower lobes. We sliced the lobes 1 cm thick and made gamma camera images of the slices. We then cut three or four slices in each lobe into two or three concentric layers and measured the radioactivity per gram of tissue in a well-type gamma counter. In three of the dogs we also labeled the red cells (99mTc) so that blood volume in each sample could be determined. The gamma camera images were acquired on a 64 X 64 matrix with 4 X 4 mm pixels. On the numeric printouts from the individual slices we made two or three concentric layers and calculated activity per pixel in each layer. Neither by the well counting nor by the pixel analysis of the gamma scans did we detect any gravity-independent distribution of blood flow. With the well counting the distribution was the same whether macroaggregate activity was expressed per gram of tissue or per gram of blood-free tissue. We conclude that by direct measurements no major gravity-independent gradient of pulmonary blood flow can be detected in dog lungs.

Ultrasonic aspiration in coronary artery surgery

With the aid of an ultrasonically powered aspiration device, the coronary artery to undergo distal anastomosis during aortocoronary bypass grafting can be exposed in the beating heart prior to institution of cardiopulmonary bypass and systemic administration of heparin. The thick adipose tissue and bridging muscles of the superficial layer are removed with almost no bleeding, leaving the vascular elements intact. The optimal site for anastomosis of the coronary artery is readily exposed and confirmed, and aortic cross-clamp time is minimized.