Bommakanti Nikhil, Isbatan Ayman, Bavishi Avni, Dharmavaram Gourisree, Chignalia Andreia Z, Dull Randal O
1 Department of Anesthesiology, University of Illinois at Chicago, College of Medicine, Chicago, IL, USA.
2 Department of Bioengineering, University of Illinois at Chicago, College of Medicine, Chicago, IL, USA.
Pulm Circ. 2017 Jul-Sep;7(3):719-726. doi: 10.1177/2045893217724414. Epub 2017 Sep 1.
Hypercapnic acidosis (HCA) has beneficial effects in experimental models of lung injury by attenuating inflammation and decreasing pulmonary edema. However, HCA increases pulmonary vascular pressure that will increase fluid filtration and worsen edema development. To reconcile these disparate effects, we tested the hypothesis that HCA inhibits endothelial mechanotransduction and protects against pressure-dependent increases in the whole lung filtration coefficient (K). Isolated perfused rat lung preparation was used to measure whole lung filtration coefficient (K) at two levels of left atrial pressure (P = 7.5 versus 15 cm HO) and at low tidal volume (LV) versus standard tidal volume (STV) ventilation. The ratio of K/K was used as the index of whole lung permeability. Double occlusion pressure, pulmonary artery pressure, pulmonary capillary pressures, and zonal characteristics (ZC) were measured to assess effects of HCA on hemodynamics and their relationship to K/K. An increase in P from 7.5 to 15 cm HO resulted in a 4.9-fold increase in K/K during LV and a 4.8-fold increase during STV. During LV, HCA reduced K/K by 2.7-fold and reduced STV K/K by 5.2-fold. Analysis of pulmonary hemodynamics revealed no significant differences in filtration forces in response to HCA. HCA interferes with lung vascular mechanotransduction and prevents pressure-dependent increases in whole lung filtration coefficient. These results contribute to a further understanding of the lung protective effects of HCA.
高碳酸血症性酸中毒(HCA)在肺损伤实验模型中具有有益作用,可减轻炎症并减少肺水肿。然而,HCA会增加肺血管压力,进而增加液体滤过并加重水肿发展。为了协调这些不同的效应,我们检验了以下假设:HCA抑制内皮机械转导,并防止全肺滤过系数(K)因压力增加而升高。采用离体灌注大鼠肺制备方法,在两种左心房压力水平(P = 7.5对15 cm H₂O)以及低潮气量(LV)与标准潮气量(STV)通气条件下,测量全肺滤过系数(K)。K/K比值用作全肺通透性指标。测量双闭塞压力、肺动脉压力、肺毛细血管压力以及分区特征(ZC),以评估HCA对血流动力学的影响及其与K/K的关系。P从7.5 cm H₂O增加到15 cm H₂O时,LV期间K/K增加4.9倍,STV期间增加4.8倍。在LV期间,HCA使K/K降低2.7倍,使STV的K/K降低5.2倍。肺血流动力学分析显示,HCA对滤过力无显著差异。HCA干扰肺血管机械转导,并防止全肺滤过系数因压力增加而升高。这些结果有助于进一步理解HCA的肺保护作用。