2003, Number 1
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Neumol Cir Torax 2003; 62 (1)
Effect of moderate level of superimposed alveolar hypoxia on the rate of edema formation and proteins transport in a canine isolated lobe model of hydrostatic pulmonary edema, using spectrophotometric methods
Palomar A, Fernández R, Gómez A, Krüll NG, Harari R, Gertrudiz N, Martínez GML, Sandoval J, Oppenheimer L
Language: Spanish
References: 37
Page: 15-23
PDF size: 124.01 Kb.
ABSTRACT
Effect of moderate level of superimposed alveolar hypoxia on the rate of edema formation and proteins transport in a canine lobal lobe model of hydrostatic pulmonary edema, using the spectrophotometric method. Several mechanisms have been implicated in the genesis of pulmonary edema related to alveolar hypoxia. In this experimental model, we studied the pulmonary edema formation at different oxygen inspiratory fractions. In 12 isolated blood perfused and statically inflated canine left lower lobes, we measured continuously the rate of transvascular fluid exchange (Qf) at two levels of inspiratory oxygen fraction (FIO
2) and the same inspiratory CO
2 fraction, Qf was continuously determined from changes in light transmission (815 nm) proportional to changes in hematocrit. We increased Qf by changes in hydrostatic pressure (capillary pressure 25.2 ± 0.74 cm H
2O). The Qf measurements were performed during two conditions in all lobes. Normoxia = FIO
2
21% and hypoxia = FIO
2 5%. Seven lobes started with normoxia and 5 with hypoxia. Both conditions lasted 30 minutes.
Results: The PaO
2 was significantly different between hypoxia (49.28 ± 7.8 mmHg) and normoxia (123 ± 24.1 mmHg). The Qf during normoxia was 0.469 ±0.33 and 0.358 ± 0.2mL/min/100 g during hypoxia, P = NS. Qf as assessed by continuous weight recording was also not different in both conditions. In a second group of experiments using the
same protocol, in eight separate experiments we calculated the reflection coefficients of the membrane (σ), using dyed plasma proteins with Evans blue and calculating the plasma concentration with spectrophotometry at 610 nm. The σ during normoxia was 0.66± 0.17 and 0.63 ± 0.21 in hypoxia P = NS.
Conclusion: In this
model of pulmonary edema, moderate alveolar hypoxia does not produce any significant change in Qf and σ.
REFERENCES
Starling EH. On the absorption of fluid from the connective tissue spaces. J Physiol. (London). 1896; 19: 312-26.
Fitz-Roy E. Curry: Mechanic and thermodynamics of transcapillary exchange. Handbook of Physiology. Chapter 8., American Physiological Society. 1984; Sec 2, Vol IV: 309-374.
Palomar A, Furuya ME, Gómez A, Martínez-Guerra ML, Gertrudiz N, Oppenheimer L, Sandoval J. Espectrofotometría continua como método para el estudio del edema pulmonar en una preparación de lóbulo pulmonar canino aislado. Arch Inst Cardiol Méx 1996; (66): 10-22.
Cope D, Grimbert F, Downey J, Taylor AE. Pulmonary capillary pressure: A review. Crit Care Med 1992; 20: 1043-1056.
Murray J, Nadel J. Textbook of respiratory medicine. Editorial Saunders 2a edición 1994, Vol. 1 p.p. 139-174. Vol 2 p.p. 1725-1777.
Von Euler, Lijestrand G. Observations on the pulmonary arterial blood pressure in the cat. Acta Physiol Scand 1946; 12: 301.
Craven KD, Oppenheimer L, Wood LD. Effect of contusion and flail chest on pulmonary perfusion and oxygen exchange. J Appl Physiol 1979; 47: 729-37.
Bärtsch P, Maggiorini M, Ritte M, Noti C, Vock P, Oelz O. Prevention of high-altitude pulmonary edema by nifedipine. N Engl J Med 1991; 325: 1284-9.
Scherrer U, Vollenweider L, Delabays A et al. Inhaled nitric oxide for high. Altitude pulmonary edema. N Engl J Med 1996; 334: 624-9.
García J, Sandoval J, Verdejo J, García G, Prado A. Edema pulmonar de las alturas. Consideraciones fisiopatológicas a propósito de un caso. Arch Inst Cardiol Méx 1989; 59: 155-159.
White P, Sylvester J, Humphrey R, Permutt T, Permutt S, Brower R. Effect of hypoxia on lung fluid balance in ferrets. Am J Respir Crit Care Med 1994; 149: 1112-7.
West J, Mathieu-Costello O. High altitude pulmonary edema is caused by stress failure of pulmonary capillaries. Int J Sports Med 1992; 13 (suppl 1): 54-58.
Oppenheimer L, Huebert D. Near-infrared spectrophotometric device to measure fluid exchange in blood-perfused organs. J Appl Physiol 1993; 74(5): 2205-2213.
Oppenheimer L, Smit A, Palomar A. En: New therapeutic strategies. The pulmonary circulation: Moving from passive to active control. Pulmonary edema reabsorption. Ed. Michael R. Pinsky. W.B. Saunders C. London. 1996 Chapter 19, 271-282.
White P, Brower R, Sylvester J, Permutt T, Permutt S. Factors influencing measurement of protein reflection coefficient by filtered volume technique. J Appl Physiol 1993; 74: 1374-80.
Schoene R, Swenson E, Pizzo C, Hackett P, Roach R, Mills W et al. The lung a high altitude: Bronchoalveolar lavage in acute mountain sickness and pulmonary edema. J Appl Physiol 1988; 64, 6: 2605-2613.
Westendorp R, Roos A et al. Atrial natriuretic peptide improves pulmonary gas exchange in subjects exposed to hypoxia. Am Rev Respir Dis 1993; 148: 304-9.
Schoene R, Goldberg S. The quest for an animal model of high altitude pulmonary edema. Int J Sports Med 1992; 13 suppl 1: S59-S61.
Staub N. Pulmonary edema-hypoxia and overperfusion. N Engl J Med 1980; 302, 19: 1085-1086.
Jerome H, Severinghaus J. High-altitude pulmonary edema. N Engl J Med 1996; 334: 662-663.
Colice GL, Yan-Jie L, Chen J, Du H, Ramirez G, Dietz J. Susceptibility to high-altitude pulmonary edema in Madison and Hilltop rats. Ventilation and fluid balance. J Appl Physiol 1995; 78, 6: 2279-2285.
Peake MD, Harabin AL, Brennan NJ, Sylvester JT. Steady-state vascular responses to graded hypoxia in isolated lungs of five species. J Appl Physiol 1981; 51: 1214-9.
Naeije R. Pulmonary circulation in hipoxia. Int J Sports Med 1992; 13 (suppl 1): 27-30.
Peake MD, Harabin AL, Brennan NJ, Sylvester JT. Steady-state vascular response to graded hypoxia in isolated lungs of five species. J Appl Physiol 1981; 51: 1214-9.
Lloyd TC. Influence of blood pH on hypoxic pulmonary vasoconstriction. J Appl Physiol 1966; 21: 358-66.
Daly I, Michael C, Ramsey W, Wadler B. Conditions governing the pulmonary vascular response to ventilation hypoxia and hypoxemia in the dog. J Physiol Lond 1968; 196: 351-79.
Perrella M, Edell E, Krowka M, Cortese D, Burnett J Jr. Endothelium-derived relaxing factor in pulmonary and renal circulations during hypoxia. Am J Physiol 1992; 263: 45-50.
Fréden F, Wei SZ, Berglund JE, Frostell C, Hedenstierna G. Nitric oxide modulation of pulmonary blood flow distribution in lobar hypoxia. Anesthesiology 1995; 82: 1216-1225.
Schoene RB, Hackett PH, Henderson WR, Sage EH, Chow M, Roach RC et al. High-altitude pulmonary edema. Characteristic of lung lavage fluid. JAMA 1986; 256: 63-9.
Homik L, Bshouty Z, Light RB, Younes M. Effect of alveolar hypoxia on pulmonary fluid filtration in situ dog lungs. J Appl Physiol 1988; 65: 46-52.
Stelzner TS, O’Brien RF, Sato K, Weil IV. Hypoxia induced increases in pulmonary transvascular protein escape in rats. Modulation by glucocorticoids. J Clin Invest 1988; 82: 1840-7.
Smit A, Palomar A, Oppenheimer L. Spectrophotometric determination of filtration parameters in the isolated canine lung lobe preparation after raising the plasma colloid oncotic pressure. Faseb J. Feb 19, 1993. Abs No. 1354.
Furuya ME, Oppenheimer L. On line spectrophotometric determination of drag reflection coefficient in isolated lobes. Faseb J. April 1991, Abs No. 7898.
Oppenheimer L, Furuya ME, Landolfo KP, Hubert D. On line colorimetric determinations of transvascular fluid and protein transport in isolated lobes. In: Respiratory biomechanics engineering analysis of structure and function. MA Farrel. JR Ligas, eds. New York, Springer-Verlag, 1990: 169-175.
Oppenheimer L, Furuya ME. Influence of non-convective protein transport on filtration coefficient and force balance in isolated lobes. Faseb J. 1991; 5(6): A7898.
Smit A, Palomar A, Oppenhelmer L. On line spectrophotometry combined with gel filtration chromatograph in the analysis of transvascular macromolecular. Faseb J. April 1992. Abs No. 3472.
Palomar A, Smit A, Oppenheimer L. On line spectrophotometric analysis of albumin and dextran 500 transport. Faseb J. April 1992. Abs No. 3473.