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Biomedical subjects

K C Beck

Publications and source records attributed to K C Beck.

47 records · Page 3Linked to original sources
PubMed1986

Resonant amplification of delivered volume during high-frequency ventilation.

The volume of gas delivered from a high-frequency ventilation (HFV) circuit was measured with an ultrasonic flowmeter. The measurements were done in vitro (20-liter air-filled glass bottle) and in vivo (9 anesthetized dogs lying supine) at oscillation frequencies ranging from 4 to 23 Hz and stroke volumes of the pump ranging from 36 to 150 ml. We varied the length and diameter of the tube connecting the pump with the endotracheal tube, the length and diameter of the bias outflow tube, the diameter of the endotracheal tube, and the stroke volume of the pump. Both in vitro and in vivo, there was resonant amplification of the delivered gas volume; i.e., the delivered gas volume exceeded the stroke volume at certain frequencies. Altering the dimensions of connecting tube, endotracheal tube, bias outflow tube, or stroke volume, i.e., changing the resistance to gas flow, gas compliance, and/or gas inertance in these elements, altered the ratio of gas delivered to stroke volume that could be predicted by an electric analog. These data indicate that the delivered gas volume during HFV depends critically on the configuration of the HFV circuit, the size of the endotracheal tube, the oscillation frequency, and the pump stroke volume. Knowledge of the delivered gas volume during HFV and appreciation of the phenomenon of resonant amplification of the delivered gas volume will permit a more accurate description of factors contributing to gas transport during HFV.

Animals↗
PubMed1986

Differences in regional vascular conductances in isolated dog lungs.

The distribution of pulmonary blood flow is influenced by gravity, regional lung expansion, and hypoxic pulmonary vasoconstriction. However, these factors cannot completely explain the three-dimensional distribution of blood flow in the lung. The present study was designed to see whether anatomically related factors could contribute. Regional blood pressure vs. flow curves were determined in 100-230 small parenchymal samples (0.3-0.4 ml) from 12 isolated perfused dog lungs held at constant inflation pressure. In each region four blood flows were measured using radioactively labeled microspheres, and the four corresponding regional perfusion pressures were determined by correcting the measured perfusion pressure for hydrostatic effects. There were considerable differences in the slopes of the pressure vs. flow curves among lung regions. Dorso-caudal regions of the lung had higher vascular conductances than ventrocephalad regions, independent of the vertical orientation of the lung or the inflation volume during injections of microspheres. Thus the distributions of regional vascular conductances were related to the anatomic location and were not related to gravity, nor were they caused by nonuniformities in regional lung expansion or by hypoxic vasoconstriction or edema.

Animals↗
PubMed1985

Pulmonary blood flow vs. gas volume at various perfusion pressures in rabbit lung.

To obtain a detailed description of the dependence of pulmonary blood flow on changes in lung volume, we perfused isolated rabbit lungs with homologous blood at 37 degrees C while controlling vascular pressures during lung deflation. We set pulmonary arterial pressure (Ppa) and pulmonary venous pressure (Ppv) to constant values relative to alveolar pressure (Palv) to keep the effective driving pressure for flow constant during lung deflation from total lung capacity (TLC) to 25% TLC. The shapes of the flow vs. lung volume curves were dependent on the levels of Ppa-Palv and Ppv-Palv at which they were obtained. When Ppv greater than Palv throughout the lung (zone 3 conditions), flow increased as the lungs were deflated from TLC, independent of the level of Ppa-Palv. When Ppv less than Palv (zone 2 conditions) and Ppa-Palv was moderately high, flow increased as the lungs were deflated from 100 to approximately 50% TLC, then decreased at lower lung volumes. When Ppa - Palv was less than 10 cmH2O in zone 2 conditions, flow decreased monotonically during deflation from TLC. We concluded that the dependence of blood flow on lung volume is complex, which may be a reflection of the nonlinear pressure-diameter properties of pulmonary vessels.

Animals↗
PubMed1985

Direct and indirect blood pressure during exercise.

In 27 subjects, we compared rest and exercise blood pressure (BP) measurements determined directly by catheterization of the radial artery with simultaneous values obtained indirectly by auscultation of the brachial artery. As work increased, the systolic BP increased, whereas the diastolic BP did not change. Considering all comparisons, direct BP was greater than indirect BP by a mean of 29.0 mm Hg for systolic BP and 12.3 mm Hg for diastolic BP. As exercise level increased, the difference between direct and indirect systolic BP decreased whereas the difference between direct and indirect diastolic BP did not change. Both methods have advantages for assessment of BP response to exercise: normality of BP response is best assessed by auscultation, whereas beat-by-beat trends in BP are more accurately defined by the direct method.

Adolescent↗
PubMed1984

Effect of edema and height on bronchial diameter and shape in excised dog lung.

Mechanical interactions among the artery, bronchus, and lung parenchyma cause the bronchus to be pulled from a circular cross-section in such a way that the largest diameter of the bronchus ( Db2 ) lies along a line joining the centers of bronchus and artery. To effect these interactions, the peribronchovascular interstitial space must transmit stresses from the lung parenchyma to the artery and bronchus. To test how interstitial edema affects the interdependence between the artery and the bronchus, we measured orthogonal diameters ( Db2 , Db1 ) from tantulum bronchograms as a function of edema formation at a fixed transpulmonary pressure (Ptp). As lobe weight increased to three times normal, Db2 / Db1 decreased from 1.08 to 1.0 at a Ptp of 6 and 25 cm H2O. Cross-sectional area decreased only at a Ptp of 6 cm H2O. We conclude (1) that peribronchovascular interstitial (Pi) pressure became more uniform with edema present, causing the bronchus to assume a more circular shape, and (2) that it increased, causing bronchial cross-sectional area to decrease at a Ptp of 6 cm H2O. To determine whether Pi is uniform with height, in a separate group of lungs we measured Db1 as a function of height in two configurations: hilus-dependent, Db1 (d) and then inverted or hilus-nondependent, Db1 (nd). Db1 was unaffected by lobe inversion at 25, 10, 6 and 4 cm H2O Ptp. At a Ptp of 2 cm H2O, the difference Db1 (d) - Db1 (nd) was positive near the hilus, decreased to zero in the lung periphery, and increased with edema. This bronchial distortion due to lobe inversion was consistent with the effect of gravitational forces on lung parenchyma as modeled by a finite-element analysis, as was opposite to that predicted by a vertical hydrostatic gradient in Pi.

Animals↗
PubMed1984

Pleural liquid pressure measured by micropipettes in rabbits.

Pleural liquid pressure (Ppl) was measured by the micropipette servo-nulling method. In anesthetized, paralyzed, and mechanically ventilated rabbits, windows were made by dissecting away the intercostal muscle layers, exposing the parietal pleura over the right caudal lung lobe. Repeated measurements of Ppl were made at the windows by puncturing the parietal pleura with micropipettes during apnea at functional residual capacity. In five supine rabbits, Ppl relative to atmospheric pressure averaged -3.32 +/- 1.22 (SD) cmH2O at a distance of 5.64 +/- 0.34 (SD) cm above the lung base and -1.64 +/- 0.79 cmH2O at a distance of 2.35 +/- 0.64 cm above the lung base; the vertical Ppl gradient was 0.51 cmH2O/cm height. Ppl interpolated to midlung height was equal in absolute magnitude to mean lung static recoil (Pst) of 2.00 cmH2O. In prone rabbits, Ppl measured near the dorsal surface, 3.9 cm above the lung base, averaged -1.32 +/- 0.46 cmH2O on the costal surface, not statistically different in magnitude from mean Pst of 1.59 +/- 0.09. In contrast, Ppl measured at the same vertical height off the edge of the caudal lung in the costo-diaphragmatic recess was -4.64 +/- 0.65 cmH2O. We concluded from these data that Ppl was equal to pleural surface pressure over the costal surface and that the vertical gradient in Ppl was not hydrostatic, except in large fluid spaces off the sharp edges of the lung.

Animals↗
PubMed1983

Adaptation of vascular pressure-flow-volume hysteresis in isolated rabbit lungs.

Hysteresis within two pairs of variables describing the state of the lung vascular system [pulmonary arterial pressure (Ppa) and flow (Q) and Ppa and change in vascular volume (delta Vvasc)] was investigated in isolated plasma-perfused rabbit lungs. Q was increased and decreased stepwise, in series of five cycles each, while pulmonary venous pressure (Ppv) and lung volume were held constant. Changes in Vvasc were estimated from changes in fluid volume of the venous reservoir. The relationships within pairs of variables over each complete cycle were described by loops whose areas and widths were used to quantify the hysteresis. In successive cycles, these parameters decreased toward constant values (limit cycles), most of the change occurring by the second cycle. Areas of Ppa-delta Vvasc loops correlated closely with areas of Ppa-Q loops over all five cycles of a series. For Ppa-Q loops, the ratio of average pressure-width to total pressure excursion decreased from 0.15 initially to around 0.05 in the fifth cycle. It was concluded that the relationships between Ppa and Q and Ppa and delta Vvasc are markedly sensitive to vascular pressure or flow history.

Adaptation, Physiological↗
PubMed1983

Alveolar liquid pressure in excised edematous dog lung with increased static recoil.

Alveolar liquid pressure (Pliq) was measured by micropipettes in conjunction with a servo-nulling pressure measuring system in isolated air-inflated edematous dog lungs. Pliq was measured in lungs either washed with a detergent (0.01% Triton X-100) or subjected to refrigeration for 2-3 days followed by ventilation for 3 h. At 55% of total lung capacity (TLC, the volume at a transpulmonary pressure (Ptp) of 25 cmH2O before treatment), in both the Triton-washed and the ventilated lung, Ptp increased from 5 to 11 cmH2O, whereas Pliq, decreased from -3 to -11 cmH2O relative to alveolar air pressure. Similar increases in Ptp and decreases in Pliq were obtained at higher lung volumes. Alveolar surface tension (T) was estimated from the Laplace equation for a spherical air-liquid interface, assuming that the radius of curvature varies as (volume)n, for -1/3 less than n less than 1/3. For uniform expansion of alveoli (n = 1/3), estimated T was 6 and 18 dyn/cm at 55 and 85% TLC, respectively, before treatment and increased to 23 and 40 dyn/cm following either Triton washing or ventilation. If pericapillary interstitial fluid pressure (Pi) equaled Pliq in edematous lungs, increases in T might reduce Pi and increase extravascular fluid accumulation in lungs made stiff by either Triton washing or cooling and ventilation using large tidal volumes.

Animals↗
PubMed1982

Alveolar liquid pressure measured by micropipettes in isolated dog lung.

Micropipettes (2-5 microns), in conjunction with a servo-nulling system, were used to measure liquid pressure (Pliq) in subpleural alveoli of lobes of dog lungs made edematous by perfusing with plasma to a constant extravascular weight gain (W). Pliq was measured at fixed transpulmonary pressure (Ptp) in lungs whose W was more than 0.5 that of the initial weight (Wi). In six lobes at W/Wi = 0.6, Pliq, relative to alveolar pressure (Palv), was -2.6 +/- 0.4 cmH2O (mean +/- SE), -11.8 +/- 0.6, and -17.5 +/- 1.7 at deflation Ptp values of 5, 15, and 25 cmH2O, respectively. The Pliq increased to -2, -7, and -13.7, respectively, at W/Wi = 2.8. Based on a mean alveolar radius of 50 micron at Ptp at 25 cmH2O and values of Palv - Pliq, values for alveolar surface tension (tau) at W/Wi = 0.6 were 6, 30, and 44 dyn/cm at Ptp of 5, 15, and 25 cmH2O, respectively. In five other lobes at W/Wi = 0.5 and at 65 and 84% total lung capacity, tau was much higher on lung inflation than on deflation. If pericapillary interstitial fluid pressure (Pi) and Pliq were identical under edematous conditions, tau would be the main determinant of Pi.

Animals↗
PubMedDate not supplied

Reduced work of breathing after single lung transplantation for emphysema.

BACKGROUND: Pulmonary emphysema, with or without chronic bronchitis, has emerged as the most common indication for successful single lung transplantation. Although gas exchange can be expected to improve after successful transplantation, such changes do not adequately explain the improvement in dyspnea experienced by these patients and resulting in improved quality of life. METHODS: We prospectively studied the respiratory mechanics of 14 single lung transplantation recipients with pulmonary emphysema, of whom 10 have been followed up beyond 1 year. The mean age of the group was 48.8 years (range, 42 to 60 years) for the seven men and seven women. Average donor-predicted total lung capacity was 0.6 L (+0.2 [standard error]) greater than recipient-predicted total lung capacity. Comparison of pulmonary resistance, dynamic lung compliance, and static lung compliance were taken to examine the possible role of reduced airways resistance and of improved elastic recoil in the reduced work of breathing. Results were analyzed by means of a one-tailed paired Student t test and linear regression analysis (both stepwise and multivariate); results are tabulated by mean (+/- 1 [standard error]). RESULTS: Between preoperative measurements and 12 months postoperatively, maximum lung elastic recoil increased from 8.1 (+/- 0.7) to 11.3 (+/- 1.0) cm H2O, p < 0.01; pulmonary resistance fell from 8.3 (+/- 0.8) to 5.4 (+/- 0.7) cm H2O sec/L, p < 0.01. Dynamic lung compliance fell from 0.23 (+/- 0.04) to 0.12 (+/- 0.02) L/cm H2O, p < 0.02, and static lung compliance fell from 0.66 (+/- 0.13) to 0.22 (+/- 0.05) L/cm H2O, p < 0.001. CONCLUSIONS: The decline in lung compliance after single lung transplantation reflects the importance of improvement in elastic recoil and reduced chest wall distention, improving the work of breathing. The 67% decline in static lung compliance (300% increase in elastic recoil) is probably the single most important mechanical factor leading to reduced dyspnea after single lung transplantation for emphysema.

Airway Resistance↗