Gas exchange and regional redistribution of pulmonary blood flow during resuscitation of acute pulmonary bead embolization. 1992

J Y Tsang, and M Middaugh, and M Emery, and M P Hlastala
U.B.C. Pulmonary Research Laboratory, St. Paul's Hospital, Vancouver, B.C., Canada.

Acute pulmonary embolism (PE) was induced by injecting polystyrene beads into the right atrium of 18 anaesthetized dogs. The animals were resuscitated for 45 min with either Ringer's Lactate (RL), norepinephrine (NE) or isoproterenol (IP). The multiple inert gas elimination technique (MIGET) was used to estimate the distributions of ventilation (V) and blood flow (Q) to different V/Q regions. Measurements were made prior to embolism, 10 min after PE and during the resuscitative phase. Microspheres with three different radioactive labels were also used to mark blood flow distribution to different lung regions in these three phases. The data show that cardiac output decreases after PE, while perfusion to shunt and low V/Q regions increases. Pulmonary blood flow heterogeneity, estimated from the MIGET data, is also increased after PE. Resuscitation by RL or NE consistently increases cardiac output but IP does so inconsistently and is associated with systemic hypotension. All three methods of resuscitation cause increases in perfusion to the shunt and low V/Q regions but no change in perfusion heterogeneity in the remaining V/Q units. Increases in regional blood flow during resuscitation occur preferentially in the less embolized areas. The concomitant increase in perfusion to shunt and low V/Q units suggests that increased perfusion to these less embolized regions results in further hypoxemia despite improvement in cardiac output.

UI MeSH Term Description Entries
D007545 Isoproterenol Isopropyl analog of EPINEPHRINE; beta-sympathomimetic that acts on the heart, bronchi, skeletal muscle, alimentary tract, etc. It is used mainly as bronchodilator and heart stimulant. Isoprenaline,Isopropylarterenol,4-(1-Hydroxy-2-((1-methylethyl)amino)ethyl)-1,2-benzenediol,Euspiran,Isadrin,Isadrine,Isopropyl Noradrenaline,Isopropylnoradrenaline,Isopropylnorepinephrine,Isoproterenol Hydrochloride,Isoproterenol Sulfate,Isuprel,Izadrin,Norisodrine,Novodrin,Hydrochloride, Isoproterenol,Noradrenaline, Isopropyl,Sulfate, Isoproterenol
D008863 Microspheres Small uniformly-sized spherical particles, of micrometer dimensions, frequently labeled with radioisotopes or various reagents acting as tags or markers. Latex Beads,Latex Particles,Latex Spheres,Microbeads,Bead, Latex,Beads, Latex,Latex Bead,Latex Particle,Latex Sphere,Microbead,Microsphere,Particle, Latex,Particles, Latex,Sphere, Latex,Spheres, Latex
D009638 Norepinephrine Precursor of epinephrine that is secreted by the ADRENAL MEDULLA and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers, and of the diffuse projection system in the brain that arises from the LOCUS CERULEUS. It is also found in plants and is used pharmacologically as a sympathomimetic. Levarterenol,Levonorepinephrine,Noradrenaline,Arterenol,Levonor,Levophed,Levophed Bitartrate,Noradrenaline Bitartrate,Noradrénaline tartrate renaudin,Norepinephrin d-Tartrate (1:1),Norepinephrine Bitartrate,Norepinephrine Hydrochloride,Norepinephrine Hydrochloride, (+)-Isomer,Norepinephrine Hydrochloride, (+,-)-Isomer,Norepinephrine d-Tartrate (1:1),Norepinephrine l-Tartrate (1:1),Norepinephrine l-Tartrate (1:1), (+,-)-Isomer,Norepinephrine l-Tartrate (1:1), Monohydrate,Norepinephrine l-Tartrate (1:1), Monohydrate, (+)-Isomer,Norepinephrine l-Tartrate (1:2),Norepinephrine l-Tartrate, (+)-Isomer,Norepinephrine, (+)-Isomer,Norepinephrine, (+,-)-Isomer
D011652 Pulmonary Circulation The circulation of the BLOOD through the LUNGS. Pulmonary Blood Flow,Respiratory Circulation,Circulation, Pulmonary,Circulation, Respiratory,Blood Flow, Pulmonary,Flow, Pulmonary Blood,Pulmonary Blood Flows
D011655 Pulmonary Embolism Blocking of the PULMONARY ARTERY or one of its branches by an EMBOLUS. Pulmonary Thromboembolism,Thromboembolism, Pulmonary,Embolism, Pulmonary,Embolisms, Pulmonary,Pulmonary Embolisms,Pulmonary Thromboembolisms,Thromboembolisms, Pulmonary
D011659 Pulmonary Gas Exchange The exchange of OXYGEN and CARBON DIOXIDE between alveolar air and pulmonary capillary blood that occurs across the BLOOD-AIR BARRIER. Exchange, Pulmonary Gas,Gas Exchange, Pulmonary
D012151 Resuscitation The restoration to life or consciousness of one apparently dead. (Dorland, 27th ed) Resuscitations
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia

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