Ewing-Bui David, Mink Steven N
Section of Thoracic Surgery, Department of Surgery, and Section of Respiratory Diseases, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada R3E-0Z3.
J Appl Physiol (1985). 2002 Jan;92(1):100-8. doi: 10.1152/jappl.2002.92.1.100.
The effect of pulmonary resection on the maximal emptying of the remaining lobes was examined in an open-chest preparation in normal canine lungs and in a unilobar papain emphysema model. The objectives were to determine whether, compared with when both lungs were deflated (BL), maximal emptying of the normal lower lobes or the emphysematous right lower lobe would be altered 1) when acute pneumonectomy of the contralateral lung was performed (OL) and 2) when the lower lobe deflated alone (LA). The alveolar capsule technique was used to measure alveolar pressures (Palv) at 75, 50, and 30% lobar vital capacity (VC). During forced deflation, the maximal rates of deflation (dPalv/dt) and flows (lobarV(max)) of the lower lobes were determined under the three different conditions. The Pitot-static tube technique was used to measure intrabronchial pressures and to estimate bronchial area and compliance in which values were obtained at the same central airway during the conditions studied. The results showed that, compared with BL and OL, dPalv/dt and lobar V(max) decreased during LA (P < 0.05). These findings were due to a reduction in bronchial area during LA that limited flow at a lower maximal value compared with BL. This decrease in area appeared to be due to a change in bronchial pressure area behavior that resulted in a smaller bronchial area during LA for similar transmural pressures between conditions. There were no differences in findings between normal and emphysematous lobes. This study suggested that removal of lobes may alter the pressure area behavior of central airways. Possible mechanisms considered were differences in axial tension between conditions, negative effort dependence, or parenchymal-bronchial interdependence that may be relevant to understanding the dynamic collapsibility of central as well as intraparenchymal airways.
在正常犬肺的开胸实验以及单叶木瓜蛋白酶诱导的肺气肿模型中,研究了肺切除对剩余肺叶最大排空的影响。目的是确定与双肺萎陷(BL)时相比,正常下叶或肺气肿右下叶的最大排空在以下两种情况下是否会改变:1)对侧肺进行急性肺切除时(OL);2)仅下叶萎陷时(LA)。采用肺泡囊技术在肺叶肺活量(VC)的75%、50%和30%时测量肺泡压力(Palv)。在强制呼气过程中,在三种不同条件下测定下叶的最大呼气速率(dPalv/dt)和流量(肺叶V(max))。采用皮托管技术测量支气管内压力,并估计支气管面积和顺应性,在研究的条件下于同一中央气道获取这些值。结果显示,与BL和OL相比,LA期间dPalv/dt和肺叶V(max)降低(P<0.05)。这些发现是由于LA期间支气管面积减小,与BL相比,在较低的最大值时限制了流量。面积的减小似乎是由于支气管压力面积行为的改变,导致在LA期间,在不同条件下跨壁压力相似时支气管面积更小。正常肺叶和肺气肿肺叶的研究结果没有差异。本研究提示,肺叶切除可能会改变中央气道的压力面积行为。考虑的可能机制包括不同条件下轴向张力的差异、负性用力依赖性或实质-支气管相互依赖性,这些可能与理解中央气道以及实质内气道的动态塌陷有关。