Reducing lung strain after pneumonectomy impairs oxygen diffusing capacity but not ventilation-perfusion matching

Connie C W Hsia, Robert L. Johnson, Eugene Y. Wu, Aaron S. Estrera, Harrieth Wagner, Peter D. Wagner

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

After pneumonectomy (Pnx), mechanical strain on the remaining lung is an important signal for adaptation. To examine how mechanical lung strain alters gas exchange adaptation after Pnx, we replaced the right lung of adult dogs with a custom-shaped inflatable silicone prosthesis. The prosthesis was kept 1) inflated (Inf) to reduce mechanical strain of the remaining lung and maintain the mediastinum in the midline, or 2) deflated (Def) to allow lung strain and mediastinal shift. Gas exchange was studied 4-7 mo later at rest and during treadmill exercise by the multiple inert gas elimination technique while animals breathed 21 and 14% O2 in balanced order. In the Inf group compared with Def group during hypoxic exercise, arterial O2 saturation was lower and alveolar-arterial O2 tension difference higher, whereas O2 diffusing capacity was lower at any given cardiac output. Dispersion of the perfusion distribution was similar between groups at rest and during exercise. Dispersion of the ventilation distribution was lower in the Inf group at rest, associated with a much higher respiratory rate, but rose to similar levels in both groups during hypoxic exercise. Mean pulmonary arterial pressure at a given cardiac output was higher in the Inf group, whereas peak cardiac output was similar between groups. Thus creating lung strain by post-Pnx mediastinal shift primarily enhances diffusive gas exchange with only minor effects on ventilation-perfusion matching, consistent with the generation of additional alveolar-capillary surfaces but not conducting airways and blood vessels.

Original languageEnglish (US)
Pages (from-to)1370-1378
Number of pages9
JournalJournal of Applied Physiology
Volume95
Issue number4
StatePublished - Oct 1 2003

Fingerprint

Pneumonectomy
Ventilation
Perfusion
Oxygen
Lung
Gases
Cardiac Output
Prostheses and Implants
Arterial Pressure
High Cardiac Output
Noble Gases
Mediastinum
Silicones
Respiratory Rate
Blood Vessels
Dogs

Keywords

  • Exercise
  • Mediastinal shift
  • Multiple inert gas elimination technique
  • Ventilation-perfusion distribution

ASJC Scopus subject areas

  • Physiology
  • Endocrinology
  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Reducing lung strain after pneumonectomy impairs oxygen diffusing capacity but not ventilation-perfusion matching. / Hsia, Connie C W; Johnson, Robert L.; Wu, Eugene Y.; Estrera, Aaron S.; Wagner, Harrieth; Wagner, Peter D.

In: Journal of Applied Physiology, Vol. 95, No. 4, 01.10.2003, p. 1370-1378.

Research output: Contribution to journalArticle

Hsia, CCW, Johnson, RL, Wu, EY, Estrera, AS, Wagner, H & Wagner, PD 2003, 'Reducing lung strain after pneumonectomy impairs oxygen diffusing capacity but not ventilation-perfusion matching', Journal of Applied Physiology, vol. 95, no. 4, pp. 1370-1378.
Hsia, Connie C W ; Johnson, Robert L. ; Wu, Eugene Y. ; Estrera, Aaron S. ; Wagner, Harrieth ; Wagner, Peter D. / Reducing lung strain after pneumonectomy impairs oxygen diffusing capacity but not ventilation-perfusion matching. In: Journal of Applied Physiology. 2003 ; Vol. 95, No. 4. pp. 1370-1378.
@article{3d52d26f0e8446019fb98a2bf0a2f943,
title = "Reducing lung strain after pneumonectomy impairs oxygen diffusing capacity but not ventilation-perfusion matching",
abstract = "After pneumonectomy (Pnx), mechanical strain on the remaining lung is an important signal for adaptation. To examine how mechanical lung strain alters gas exchange adaptation after Pnx, we replaced the right lung of adult dogs with a custom-shaped inflatable silicone prosthesis. The prosthesis was kept 1) inflated (Inf) to reduce mechanical strain of the remaining lung and maintain the mediastinum in the midline, or 2) deflated (Def) to allow lung strain and mediastinal shift. Gas exchange was studied 4-7 mo later at rest and during treadmill exercise by the multiple inert gas elimination technique while animals breathed 21 and 14{\%} O2 in balanced order. In the Inf group compared with Def group during hypoxic exercise, arterial O2 saturation was lower and alveolar-arterial O2 tension difference higher, whereas O2 diffusing capacity was lower at any given cardiac output. Dispersion of the perfusion distribution was similar between groups at rest and during exercise. Dispersion of the ventilation distribution was lower in the Inf group at rest, associated with a much higher respiratory rate, but rose to similar levels in both groups during hypoxic exercise. Mean pulmonary arterial pressure at a given cardiac output was higher in the Inf group, whereas peak cardiac output was similar between groups. Thus creating lung strain by post-Pnx mediastinal shift primarily enhances diffusive gas exchange with only minor effects on ventilation-perfusion matching, consistent with the generation of additional alveolar-capillary surfaces but not conducting airways and blood vessels.",
keywords = "Exercise, Mediastinal shift, Multiple inert gas elimination technique, Ventilation-perfusion distribution",
author = "Hsia, {Connie C W} and Johnson, {Robert L.} and Wu, {Eugene Y.} and Estrera, {Aaron S.} and Harrieth Wagner and Wagner, {Peter D.}",
year = "2003",
month = "10",
day = "1",
language = "English (US)",
volume = "95",
pages = "1370--1378",
journal = "Journal of Applied Physiology",
issn = "0161-7567",
publisher = "American Physiological Society",
number = "4",

}

TY - JOUR

T1 - Reducing lung strain after pneumonectomy impairs oxygen diffusing capacity but not ventilation-perfusion matching

AU - Hsia, Connie C W

AU - Johnson, Robert L.

AU - Wu, Eugene Y.

AU - Estrera, Aaron S.

AU - Wagner, Harrieth

AU - Wagner, Peter D.

PY - 2003/10/1

Y1 - 2003/10/1

N2 - After pneumonectomy (Pnx), mechanical strain on the remaining lung is an important signal for adaptation. To examine how mechanical lung strain alters gas exchange adaptation after Pnx, we replaced the right lung of adult dogs with a custom-shaped inflatable silicone prosthesis. The prosthesis was kept 1) inflated (Inf) to reduce mechanical strain of the remaining lung and maintain the mediastinum in the midline, or 2) deflated (Def) to allow lung strain and mediastinal shift. Gas exchange was studied 4-7 mo later at rest and during treadmill exercise by the multiple inert gas elimination technique while animals breathed 21 and 14% O2 in balanced order. In the Inf group compared with Def group during hypoxic exercise, arterial O2 saturation was lower and alveolar-arterial O2 tension difference higher, whereas O2 diffusing capacity was lower at any given cardiac output. Dispersion of the perfusion distribution was similar between groups at rest and during exercise. Dispersion of the ventilation distribution was lower in the Inf group at rest, associated with a much higher respiratory rate, but rose to similar levels in both groups during hypoxic exercise. Mean pulmonary arterial pressure at a given cardiac output was higher in the Inf group, whereas peak cardiac output was similar between groups. Thus creating lung strain by post-Pnx mediastinal shift primarily enhances diffusive gas exchange with only minor effects on ventilation-perfusion matching, consistent with the generation of additional alveolar-capillary surfaces but not conducting airways and blood vessels.

AB - After pneumonectomy (Pnx), mechanical strain on the remaining lung is an important signal for adaptation. To examine how mechanical lung strain alters gas exchange adaptation after Pnx, we replaced the right lung of adult dogs with a custom-shaped inflatable silicone prosthesis. The prosthesis was kept 1) inflated (Inf) to reduce mechanical strain of the remaining lung and maintain the mediastinum in the midline, or 2) deflated (Def) to allow lung strain and mediastinal shift. Gas exchange was studied 4-7 mo later at rest and during treadmill exercise by the multiple inert gas elimination technique while animals breathed 21 and 14% O2 in balanced order. In the Inf group compared with Def group during hypoxic exercise, arterial O2 saturation was lower and alveolar-arterial O2 tension difference higher, whereas O2 diffusing capacity was lower at any given cardiac output. Dispersion of the perfusion distribution was similar between groups at rest and during exercise. Dispersion of the ventilation distribution was lower in the Inf group at rest, associated with a much higher respiratory rate, but rose to similar levels in both groups during hypoxic exercise. Mean pulmonary arterial pressure at a given cardiac output was higher in the Inf group, whereas peak cardiac output was similar between groups. Thus creating lung strain by post-Pnx mediastinal shift primarily enhances diffusive gas exchange with only minor effects on ventilation-perfusion matching, consistent with the generation of additional alveolar-capillary surfaces but not conducting airways and blood vessels.

KW - Exercise

KW - Mediastinal shift

KW - Multiple inert gas elimination technique

KW - Ventilation-perfusion distribution

UR - http://www.scopus.com/inward/record.url?scp=0141567930&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0141567930&partnerID=8YFLogxK

M3 - Article

C2 - 12794035

AN - SCOPUS:0141567930

VL - 95

SP - 1370

EP - 1378

JO - Journal of Applied Physiology

JF - Journal of Applied Physiology

SN - 0161-7567

IS - 4

ER -