[Influence of inert gases upon the alveolar-arterial O2-pressure difference]

Density-dependent reduction of nitric oxide diffusing capacity after pneumonectomy

Airway lengthening after pneumonectomy (PNX) may increase diffusive resistance to gas mixing (1/D(G)); the effect is accentuated by increasing acinar gas density but is difficult to detect from lung CO-diffusing capacity (Dl(CO)). Because lung NO-diffusing capacity (Dl(NO)) is three- to fivefold that of Dl(CO), whereas 1/D(G) for NO and CO are similar, we hypothesized that a density-dependent fractional reduction would be greater for Dl(NO) than for Dl(CO). We measured Dl(NO) and Dl(CO) at two tidal volumes (Vt) and with three background gases [helium (He), nitrogen (N(2)), and sulfur hexafluoride (SF(6))] in immature dogs 3 and 9 mo after right PNX (5 and 11 mo of age). At maturity (11 mo), background gas density had no effect on Dl(NO), Dl(CO), or Dl(NO)-to-Dl(CO) ratio in sham controls. In PNX animals, Dl(NO) declined 25-50% in SF(6) relative to He and N(2), and Dl(NO)/Dl(CO) declined approximately 50% in SF(6) relative to He at a Vt of 15 ml/kg, consistent with a significant 1/D(G). At 5 mo of age, Dl(NO)/Dl(CO) declined 25-45% in SF(6) relative to He and N(2) in both groups, but Dl(CO) increased paradoxically in SF(6) relative to N(2) or He by 20-60%. Findings suggest that SF(6), besides increasing 1/D(G), may redistribute ventilation and/or enhance acinar penetration of the convective front.

Effects of gas density on pulmonary gas exchange of normal man at rest and during exercise

Changes in the physical properties of inspired gas might be expected to influence the distribution of ventilation in the lungs as well as the diffusive and convective (cardiogenic) mixing of inspired gas with lung residual gas, thus possibly affecting pulmonary gas exchange for O2 and CO2. The purpose of our work was to assess to what extent this occurs in practise in human subjects, who could compensate for the changes directly brought about by altering the physical characteristics of the inhaled gas by changing their breathing pattern. Six healthy, non-smoking men breathed, at rest and during moderate exercise, gas mixtures containing 21% oxygen completed either by 79% nitrogen (air), helium (O2-He) or sulphur hexafluoride (O2-SF6). We observed that the inhalation of these three different gas mixtures whilst at rest did not affect arterial partial pressures of O2 or CO2, the physiological dead space to tidal volume ratio, or the alveolo-aADCO2). During exercise, AaDO2 was slightly (2-3 mm Hg) but significantly higher with both O2-He and O2-SF6 than with air. Although minute ventilation did not change, breathing frequency was slightly but significantly affected by the type of gas mixture breathed, being lower with O2-SF6 and higher with O2-He. We conclude that, within the range studied, the physical properties of the inhaled gas do not affect pulmonary gas exchange in healthy man, either because the changes affected are minimal or because they compensate for each other.

Pulmonary gas exchange in dogs ventilated with mixtures of oxygen with various inert gases

To study the influence of physical properties of the respired gas on alveolar gas exchange, alveolar-arterial partial pressure differences for O2 and CO2 were measured in anesthetized dogs that were artificially ventilated with gas mixtures of O2 in N2, He, Ar or SF6. In both hyposia and normoxia alveolar-arterial PO2 differences had the tendency to increase slightly in the sequence of the respired inert gases SF6 less than Ar less than N2 less than He, while arterial-alveolar PCO2 differences remained practically unchanged. Pulmonary diffusing capacity for CO(DCO), determined by the single breath technique, revealed no significant differences between the four gas mixtures used. The possible mechanisms underlying these results are discussed in connection with the physical properties of the respired gas mixtures.