Mechanics of edematous lungs

被引:49
作者
Wilson, TA
Anafi, RC
Hubmayr, RD
机构
[1] Univ Minnesota, Dept Aerosp Engn & Mech, Minneapolis, MN 55455 USA
[2] Mayo Clin & Mayo Fdn, Div Pulm & Crit Care Med, Rochester, MN 55409 USA
关键词
pressure-volume curve; surface tension; regional ventilation; acute lung injury;
D O I
10.1152/jappl.2001.90.6.2088
中图分类号
Q4 [生理学];
学科分类号
071003 ;
摘要
Using the parenchymal marker technique, we measured pressure (P)-volume (P-V) curves of regions with volumes of similar to1 cm(3) in the dependent caudal lobes of oleic acid-injured dog lungs, during a very slow inflation from P = 0 to P = 30 cmH(2)O. The regional P-V curves are strongly sigmoidal. Regional volume, as a fraction of volume at total lung capacity, remains constant at 0.4-0.5 for airway P values from 0 to similar to 20 cmH(2)O and then increases rapidly, but continuously, to 1 at P = similar to 25 cmH(2)O. A model of parenchymal mechanics was modified to include the effects of elevated surface tension and fluid in the alveolar spaces. P-V curves calculated from the model are similar to the measured P-V curves. At lower lung volumes, P increases rapidly with lung volume as the air-fluid interface penetrates the mouth of the alveolus. At a value of P = similar to 20 cmH(2)O, the air-fluid interface is inside the alveolus and the lung is compliant, like an air-filled lung with constant surface tension. We conclude that the properties of the P-V curve of edematous lungs, particularly the knee in the P-V curve, are the result of the mechanics of parenchyma with constant surface tension and partially fluid-filled alveoli, not the result of abrupt opening of airways or atelectatic parenchyma.
引用
收藏
页码:2088 / 2093
页数:6
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