Emery Michael J, Eveland Randy L, Kim Seong S, Hildebrandt Jacob, Swenson Erik R
Department of Physiology, University of Washington School of Medicine, USA.
J Appl Physiol (1985). 2007 Aug;103(2):710-6. doi: 10.1152/japplphysiol.00128.2006. Epub 2007 May 10.
CO(2) regulation of lung compliance is currently explained by pH- and CO(2)-dependent changes in alveolar surface forces and bronchomotor tone. We hypothesized that in addition to, but independently of, those mechanisms, the parenchyma tissue responds to hypercapnia and hypocapnia by relaxing and contracting, respectively, thereby improving local matching of ventilation (Va) to perfusion (Q). Twenty adult rats were slowly ventilated with modified Krebs solution (rate = 3 min(-1), 37 degrees C, open chest) to produce unperfused living lung preparations free of intra-airway surface forces. The solution was gassed with 21% O(2), balance N(2), and CO(2) varied to produce alveolar hypocapnia (Pco(2) = 26.1 +/- 2.4 mmHg, pH = 7.56 +/- 0.04) or hypercapnia (Pco(2) = 55.0 +/- 2.3 mmHg, pH = 7.23 +/- 0.02). The results show that lung recoil, as indicated from airway pressure measured during a breathhold following a large volume inspiration, is reduced approximately 30% when exposed to hypercapnia vs. hypocapnia (P < 0.0001, paired t-test), but stress relaxation and flow-dependent airway resistance were unaltered. Increasing CO(2) from hypo- to hypercapnic levels caused a substantial, significant decrease in the quasi-static pressure-volume relationship, as measured after inspiration and expiration of several tidal volumes, but hysteresis was unaltered. Furthermore, addition of the glycolytic inhibitor NaF abolished CO(2) effects on lung recoil. The results suggest that lung parenchyma tissue relaxation, arising from active elements in response to increasing alveolar CO(2), is independent of (and apparently in parallel with) passive tissue elements and may actively contribute to Va/Q matching.
目前,肺顺应性的二氧化碳调节是通过肺泡表面力和支气管运动张力中依赖pH值和二氧化碳的变化来解释的。我们推测,除了这些机制外,实质组织分别通过舒张和收缩对高碳酸血症和低碳酸血症作出反应,从而改善局部通气(Va)与灌注(Q)的匹配。用改良的克雷布斯溶液(速率 = 3次/分钟,37℃,开胸)对20只成年大鼠进行缓慢通气,以制备无气道内表面力的无灌注活体肺标本。溶液用21% O₂、其余为N₂进行气体混合,并改变二氧化碳浓度以产生肺泡低碳酸血症(Pco₂ = 26.1 ± 2.4 mmHg,pH = 7.56 ± 0.04)或高碳酸血症(Pco₂ = 55.0 ± 2.3 mmHg,pH = 7.23 ± 0.02)。结果表明,在大容量吸气后的屏气期间测量的气道压力所显示的肺回缩,与低碳酸血症相比,暴露于高碳酸血症时降低了约30%(P < 0.0001,配对t检验),但应力松弛和流量依赖性气道阻力未改变。将二氧化碳从低碳酸血症水平增加到高碳酸血症水平会导致在几个潮气量的吸气和呼气后测量的准静态压力-容积关系大幅显著下降,但滞后现象未改变。此外,添加糖酵解抑制剂氟化钠消除了二氧化碳对肺回缩的影响。结果表明,肺实质组织的舒张源于活性成分对肺泡二氧化碳增加的反应,独立于(且显然与)被动组织成分平行,可能对Va/Q匹配有积极贡献。