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Biomedical subjects

G M Saidel

Publications and source records attributed to G M Saidel.

At least 73 records · Page 4Linked to original sources

Inspiratory flow effects on mechanically ventilated patients: lung volume, inhomogeneity, and arterial oxygenation.

Changes in the inspiratory flow rate of mechanically ventilated patients can affect arterial oxygenation. Although the mechanism producing this alteration is not certain, one possible mechanism is a change in ventilation inhomogeneity. This study was performed to determine if the inspiratory flow setting would affect ventilation inhomogeneity in patients who have minimal or no lung disease, but who require mechanical ventilation after cardiopulmonary bypass surgery. When inspiratory flows were doubled, PaO2 increased and FRC fell. However, no associated change in ventilation inhomogeneity was detected. It is concluded that inspiratory flow rate can affect arterial oxygenation of subjects without severe obstructive pulmonary disease through mechanisms other than altering ventilation inhomogeneity, such as changes in cardiac output or in distribution of perfusion.

Coronary Artery Bypass↗

Static mechanics of excised whole lung: theoretical framework and experimental studies.

A theoretical framework is presented in which to view models of static pulmonary mechanics. To test common simplifying assumptions of these models, we performed a set of experiments using normal lungs excised from dogs. Transpulmonary pressure (Ptp) and lung volume (VL) were measured for air-filled lungs in air and saline-filled lungs in saline during stepwise-static deflations at different vascular volumes and temperatures. Simultaneously, we measured displacements between points on the lung surface. Changes in vascular volume shift the location but not the shape of the Ptp-VL relationship. As long as the vascular pressure is in the normal range, changes in the volume (and weight) of the perfusate do not significantly stiffen the parenchyma. Furthermore, Ptp-VL data obtained between 16 degrees C and 40 degrees C were superimposable, indicating that parenchymal mechanical properties evaluated at room temperature are valid at body temperature. Finally, the common assumptions of uniform deflation, homogeneity, and isotropy of bulk lung tissue appear consistent with the relationship between surface displacement and volume changes.

Animals↗

Static mechanics of excised whole lung: pleural mechanics.

Continuum analyses of lung mechanics require that the boundary condition of stress transmitted to the outermost alveoli be known. Depending upon the exact geometry of the pleural-parenchymal coupling, this stress could possibly be influenced by the pleural mechanical properties. The relation between pleural tension and extension ratio was obtained from tissue specimens from mongrel dog lungs. Using the worst-case geometry, this relationship was compared with the equivalent relation between pressure and volume ratio for the whole lung of the same mongrel dogs. The results of this comparison and a suitable mathematical analysis indicate that the pleura transmits applied pressure differences to the underlying alveolar walls essentially without modification.

Animals↗

A model of intestinal iron absorption and plasma iron kinetics: optimal parameter estimates for normal dogs.

A multicompartment model describing the physiological processes of intestinal iron absorption has been developed. The model accounts for uptake by the intestinal mucosa of iron in the lumen, followed by either iron incorporation into a mucosal storage pool (presumably ferritin) or direct iron transfer to the plasma. To enable analysis of iron absorption from noninvasive measurements, plasma iron kinetics were also analyzed. The model was validated in studies of three beagle dogs given oral 59Fe-citrate and intravenous 55Fe-transferrin simultaneously. Model parameters were estimated from the best (least-squares) fit of the model outputs to the tracer iron activity in venous blood samples and in the whole body. The parameter values show that both incorporation of iron into the mucosal storage pool and transfer of iron from the mucosa to the plasma occur at rates approximately 100 times greater than mucosal uptake of iron from the gut lumen. Further, release of iron from mucosal storage, while measurable, occurs at a slow rate. The study demonstrates the practicality of this noninvasive approach for the simultaneous study of iron absorption and plasma iron kinetics.

Animals↗

Dynamic water vapor and temperature calibration system.

The objective evaluation of thermal and humidification processes in the pulmonary system requires accurate dynamic measurements of temperature and water vapor concentration of a flowing gas mixture. The adequacy of instruments used for such measurements can only be determined by dynamic calibration techniques. We have developed a method of producing step changes in temperature and water vapor content of a gas mixture undergoing controlled steady flow. The system consists of two reservoirs and a slide valve that switches a test section between them. The inlet (usually a probe or catheter tip) of the device to be calibrated is positioned in the test section. The flow rate through the test section is minimally changed during the transition between gas from one reservoir to that of the other. The system has been used to analyze the response of a thermistor and a respiratory mass spectrometer to changes in gas temperature and water vapor.

Calibration↗

Measurement system for respiratory water vapor and temperature dynamics.

An instrumentation system has been developed to simultaneously measure water vapor and temperature at the same point within respiratory airways during breathing. A mass spectrometer was used to analyze gas continuously sampled through a modified inlet catheter. At the tip of the catheter, gas temperature is sensed by a microbead thermistor. Adequate water vapor dynamics is achieved by a two-step procedure. First, the tip of the sampling catheter is constricted to reduce the catheter's internal pressure and thereby prevent condensation and evaporation. Second, the water vapor signal from the mass spectrometer is compensated electronically to improve its transient response. As part of the evaluation of the system, water vapor and gas temperature were measured in the oropharynx of human subjects.

Adult↗

Mechanics and gas distribution in normal and obstructed lungs during tidal breathing.

Quantitative characteristics of the dynamic mechanical and gas distribution behavior in 6 normal subjects and 5 subjects with COPD were compared during tidal breathing. Transpulmonary pressure, total lung volume, flow, and N2 fraction at the mouth were measured while N2 was washed out from the lung. The washouts were performed at several frequencies and lung volumes. As an index of nonuniform mechanical behavior, we calculated the frequency variation in dynamic pulmonary compliance (CLdyn). Based on a moment analysis of the multibreath N2 washout, we calculated a mean dilution number (MDN) as an index of the inhomogeneity of alveolar gas distribution and mixing. At FRC or above FRC the CLdyn decreased much more with frequency for the COPD subjects than for the normal subjects. The MDN was also much greater in the presence of COPD. However, the frequency dependence of the MDN was small for both the normal and COPD subjects and uncorrelated with the frequency dependence of CLdyn. Because the multibreath N2 washout and the frequency dependence of CLdyn reflect different aspects of ventilation inhomogeneity, these two responses are unique.

Adolescent↗

Ventilation inhomogeneity: alveolar mechanics and gas distribution.

The effects of regional lung differences in alveolar mechanics on the transpulmonary pressure-volume (Ptp-V) relationship and the single-breath washout (SBW) of nitrogen were investigated by mathematical modeling and postmorten human lung experiments. Regional nonuniformity in alveolar collapse and re-opening were associated with differences in gravitational stress or elasticity. Model simulations predict that neither type of regional nonuniformity qualitatively affects the shape of the Ptp-V curve, but does affect the terminal (or small-volume) portion of the SBW. Comparisons of characteristics of the Ptp-V and SBW curves indicate that regional nonuniformity in alveolar collapse is an important mechanism associated with ventilation inhomogeneity.

Adult↗

Model simulation of heat and water transport dynamics in an airway.

Heat and water transport processes in the respiratory tract depend on environmental conditions, breathing patterns, and the physiological state of the respiratory system. To study these processes, we have developed a mathematical model of the dynamics of temperature and water vapor in the radial and axial directions of an idealized trachea. The model is expressed as two implicit finite-difference equations and solved using an alternating-direction algorithm. Using these equations, we simulated the effects of inspired gas temperature and humidity, velocity profile, and flow rate on heat and water transport between the gas and airway wall. Under inspired gas conditions of low temperature or high relative humidity, supersaturation occurs. Increasing either the velocity gradient at the wall or the flow rate increases the heat and water transport rates. However, these rates change by only 10 percent when the velocity gradient is doubled, and by about 35 percent when flow rate undergoes a two-fold change. The model can be used with in-vivo data from the trachea to test hypotheses concerning normal and abnormal heat and water transport.

Hot Temperature↗

Pulmonary blood flow and tissue volume: model analysis of rebreathing estimation methods.

As the basis for comparing rebreathing methods of estimating pulmonary blood flow (Q) and tissue-capillary volume (Vtc), we use a dynamic mass-balance model for gas species having different physicochemical properties (e.g., He, CO, C2H2). The model accounts for the effects of ventilation and perfusion inhomogeneities, breathing pattern variation, lung and rebreathing-bag volumes, and recirculation. Also, we examine the variability of the estimates caused by random error. In addition to analyzing two well-known methods, we show how an appropriate synthesis of these methods can lead to improved estimates.

Humans↗

Relationship of ventilation inhomogeneity to morphologic variables in excised human lungs.

Ventilation inhomogeneity, as assessed by the regional distribution of 133Xe and the single breath washout (SBW) curve, is compared with the morphologic aspects in excised human lungs. Morphologic measurements include central airway diameter, bronchial gland area, peripheral airway diameter, and the alveolar surface-to-volume ratio. Lung inflation with a constant concentration of 133Xe results in relatively more 133Xe distributed to the lung base than to the apex. Neither the vertical gradient in ventilation nor other interregional inhomogeneities in 133Xe distribution are correlated with morphologic variations in the lung. Also, interregional inhomogeneities of 133Xe distribution do not correlate with phase III slope of the SBW curve. This suggests that the phase III slope is determined primarily by intraregional ventilation inhomogeneities. Within the phase IV region of the SBW curve two distinct inflections are identified: an inflection at volume V1 and another sharper inflection at volume V2. Both the phase III slope and V2 correlate significantly (p less than 0.05) with peripheral airway diameter, indicating that parameters of the SBW curve do assess peripheral airway properties.

Humans↗