Koyama S, Lamm W J, Hildebrandt J, Albert R K
Medical Service, Veterans Administration Medical Center, Seattle, Washington 98108.
J Appl Physiol (1985). 1989 Apr;66(4):1817-23. doi: 10.1152/jappl.1989.66.4.1817.
To describe the flow characteristics of vessels open in zone 1, we perfused isolated rabbit lungs with Tyrode's solution containing 1% albumin, 4% dextran, and papaverine (0.05 mg/ml). Lungs were expanded by negative pleural pressure (Ppl) of -10, -15, -20, and -25 cmH2O. Pulmonary arterial (Ppa) and venous (Ppv) pressures were varied relative to alveolar pressure (PA = 0) and measured 5-10 mm inside the pleura (i) and outside (o) of the lungs. With Ppa(o) at -2.5 cmH2O, we constructed pressure-flow (P-Q) curves at each Ppl by lowering Ppv(o) until Q reached a maximum, indicating fully developed zone 1 choke flow. Maximum flows were negligible until Ppl fell below -10 cmH2O, then increased rapidly at Ppl of -15 and -20 cmH2O, and at Ppl of -25 cmH2O reached about 15 ml.min-1.kg body wt-1. The Ppv(o) at which flow became nearly constant depended on degree of lung inflation and was 5-8 cmH2O more positive than Ppl. As Ppv(o) was lowered below Ppa(o), Ppv(i) remained equal to Ppv(o) until Ppv(i) became fixed at a pressure 2-3 cmH2O more positive than Ppl. At this point the choke flow was therefore located in veins near the pleural boundary. No evidence of choke flow (only ohmic resistance) was seen in the intrapulmonary segment of the vessels remaining open in zone 1. With Ppv(o) held roughly at Ppl, Q could be stopped by lowering Ppa(o), at which time Ppa(i) was several cmH2O above Ppv(i), showing that intrapulmonary vessel closure had occurred.(ABSTRACT TRUNCATED AT 250 WORDS)
为描述1区开放血管的血流特性,我们用含1%白蛋白、4%右旋糖酐和罂粟碱(0.05毫克/毫升)的台氏液灌注离体兔肺。通过-10、-15、-20和-25厘米水柱的负压(Ppl)使肺扩张。肺动脉(Ppa)和静脉(Ppv)压力相对于肺泡压(PA = 0)变化,并在肺胸膜内(i)和外(o)5 - 10毫米处测量。当Ppa(o)为-2.5厘米水柱时,我们通过降低Ppv(o)直至Q达到最大值来构建每个Ppl下的压力-流量(P - Q)曲线,此时表明出现完全发展的1区阻塞性血流。在Ppl降至-10厘米水柱以下之前,最大流量可忽略不计,然后在Ppl为-15和-20厘米水柱时迅速增加,在Ppl为-25厘米水柱时达到约15毫升·分钟⁻¹·千克体重⁻¹。流量几乎恒定的Ppv(o)取决于肺膨胀程度,比Ppl高5 - 8厘米水柱。当Ppv(o)降至低于Ppa(o)时,Ppv(i)保持等于Ppv(o),直到Ppv(i)固定在比Ppl高2 - 3厘米水柱的压力。因此,此时阻塞性血流位于胸膜边界附近的静脉中。在1区仍开放的血管肺内段未观察到阻塞性血流的证据(只有欧姆电阻)。当Ppv(o)大致保持在Ppl时,通过降低Ppa(o)可使Q停止,此时Ppa(i)比Ppv(i)高几厘米水柱,表明肺内血管已关闭。(摘要截于250字)