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Biomedical subjects

R E Drake

Publications and source records attributed to R E Drake.

At least 181 records · Page 10Linked to original sources

Dog lymph flow in increased capillary permeability states.

The lung lymph flow rate (QL) is increased in edema caused by an increase in lung microvascular permeability. This increase in QL could be caused by either a decrease in the effective resistance of the lymph vessels (RL), or by an increase in the effective lymph driving pressure (PL), or by a change in both RL and PL. We estimated PL and RL from the linear relationship between QL and the pressure at the outflow end (PO) of five cannulated dog lung lymph vessels (RL = - delta Po/delta QL and PL = the PO at which QL = 0). We increased lung microvascular permeability by giving the dogs 100 mg/kg of alloxan and found that QL increased from 24.5 +/- 8.9 microliters/min to 112 +/- 41 microliters/min (mean +/- SD). RL decreased from 0.35 +/- 0.12 to 0.11 +/- 0.04 cm H2O min/microliters and PL increased from 8.5 +/- 1.5 to 15.9 +/- 2.7 cm H2O. We then increased the capillary pressures from 18.3 +/- 3.8 to 41.3 +/- 7.3 cm H2O and QL increased to 169.9 +/- 47.8 microliters/min. PL increased by an additional 6.3 cm H2O but RL decreased by only an additional 0.02 cm H2O min/microliters. These results show that the QL vs PO relationship is changed in edema secondary to an increase in microvascular permeability, and that this change can be represented as changes in RL and PL. In terms of these parameters, QL increased in edema as a result of a decrease in RL and an increase in PL.

Alloxan↗

Effect of Escherichia coli endotoxin on dog lung fluid balance.

Endotoxin may cause an increase in pulmonary capillary permeability and thus promote edema formation. We used a gravimetric technique to estimate the pulmonary capillary filtration coefficient (KF) and the maximum capillary pressure at which the lung could maintain a constant weight (Pccritical) in dogs after intravenous administration of Escherichia coli (E. coli) endotoxin. KF should be increased and Pccritical should be decreased by an increase in permeability. Four groups of three to four dogs were given 1, 10, 1,000, or 3,000 micrograms/kg of endotoxin. A fifth group of five dogs, which served as controls, was given no endotoxin. KF was significantly (P less than 0.05) greater than control [0.049 +/- 0.031 (SD) ml . min-1 . mmHg-1] in only the 1-micrograms/kg group (0.100 +/- 0.027), indicating a possible increase in permeability. However, changes in capillary surface area may have affected KF. Pccritical was not significantly different from control (20.7 +/- 2.4 mmHg) in any of the E. coli groups. We conclude from these results that E. coli endotoxin may have caused a slight increase in permeability; however, the lung retained its ability to resist edema formation.

Animals↗

Relationship between weight gain and lymph flow in dog lungs.

Lung weight is a useful indicator of increases in lung extravascular volume. In addition, the lung lymph flow rate (QL) is an important factor in lung fluid balance. We have studied the weight and QL responses to elevations in capillary pressure (Pc) in intact dog lung lower left lobes. We measured lobe weight continuously. We also measured QL from small lymph vessels from the same lobes. The base-line QL was 1.7 +/- 1.5 microliter/min, and the weight was constant. After we increased Pc by 8-20 cmH2O, both weight and QL increased transiently. In most lungs the weight reached a new steady state. When we increased Pc further, weight increased continuously; however, QL reached a plateau. The continuous weight gain was due to edema. These results show that weight and QL respond similarly in nonedematous lungs; however, the weight and QL responses in edematous lungs may be different.

Animals↗

Pulmonary microvascular permeability after coronary arterial ligation in dogs.

Recent studies have indicated that pulmonary microvascular permeability may be increased after coronary arterial ligation. We tested this by estimating the pulmonary microvascular reflection coefficient (delta) in six anesthetized control dogs and in six dogs in which we ligated the left anterior descending coronary artery. We cannulated lung lymph vessels and measured the lymph and plasma protein concentrations (CL and CP, respectively). The left atrial pressure was increased to decrease CL to a minimum. We used the minimum CL to estimate delta as 1 -CL/CP. delta for the control [0.70 +/- 0.03 (SD)] and coronary artery ligated groups (0.70 +/- 0.04) were almost identical. This data indicates that coronary artery ligation does not increase pulmonary microvascular permeability.

Animals↗

Dealing with suicide on a psychiatric inpatient unit.

Suicide on an inpatient unit can cause severe trauma among patients and staff. Consequently both groups may revert to less adaptive coping styles. In general, staff's recovery is gradual and natural and may yield an opportunity for emotional growth; however, prolonged disability may also occur. The authors interviewed 23 staff members who had worked on an inpatient unit during a 16-month period when four patients committed suicide. On the basis of these interviews, the authors have developed a framework for understanding the three phases of staff reaction to suicide and guidelines for helping staff through the recovery process. They recommend that ward administrators monitor and facilitate the group process by providing protection and support during the initial phase of shock, appropriate channels and limits for the intense feelings that occur during the second phase, and constructive forums for more mature coping activities during the third phase, as staff regain their equilibrium.

Adaptation, Psychological↗

A feedback system to control blood flow in dog lung lobes.

We have developed an electromechanical feedback system to control blood flow to the lower left lung lobe of dogs. Blood flow is measured with an electromagnetic flowmeter. The feedback system compares the blood flow signal to an adjustable reference voltage and causes a motor to turn. The direction of motor rotation depends on the relative magnitude of the flow signal and the reference. The motor pushes the plunger of a syringe that is attached to a balloon in the right pulmonary artery. Inflation of the balloon causes increased blood flow to the lower left lobe. We have used the system to control lobe blood flow in three dogs.

Animals↗

Effect of outflow pressure upon lymph flow from dog lungs.

The pulmonary lymph flow rate (QL) should be a function of the lymph vessels' resistance and the pressure gradient along the vessels. We attempted to study how these factors affect lymph flow. We assumed that the lymph system could be represented by a single pressure generated within the lung (PL) and a single resistance (RL). Thus, QL should be a function of the lymph vessel outflow pressure (Po): QL = (PL - Po)/RL. We cannulated tracheobronchial lymph vessels in eight anesthetized dogs and varied Po by raising the outflow end of the cannula. QL decreased linearly when we increased Po. We estimated RL as - delta Po/ delta QL and PL as the extrapolated Po at which QL = 0. At baseline PL = 7.7 +/- 2.7 (SD) cm H2O and RL = 0.36 +/- 0.25 cm H2O. min/microliters. After we increased capillary pressure to produce edema, PL and RL averaged 22.8 +/- 8.8 and 0.14 +/- 0.12, respectively. After we reduced the capillary pressure to baseline in the edematous lungs, PL and RL averaged 11.6 +/- 2.8 and 0.08 +/- 0.09, respectively. All changes in PL and RL were significant (P less than 0.05). These results show that (1) lymph flow rate depends upon lymph vessel outflow pressure, and (2) the QL vs. Po relationship is changed by edema. PL may be equal to the pressure causing lymph to flow and RL may equal the lymph vessel resistance.

Animals↗

Effect of histamine and alloxan on canine pulmonary vascular permeability.

We estimated the pulmonary capillary membrane filtration coefficient (Kf) and the maximum capillary pressure (PCcritical) at which the lung could maintain a constant weight in 1) 5 control experiments in anesthetized open-chested dogs, 2) 7 experiments in which the dogs were given 3.6-8.3 microgram . kg-1 . min-1 of histamine phosphate, and 3) in 6 experiments after 75-100 mg/kg of alloxan. In additional experiments, pulmonary lymph flow (QL) and protein concentration (CL) were measured during the infusion of histamine and alloxan. After histamine, Kf averaged 0.045 +/- 0,008 ml . min-1mmHg-1 (SE) and PCcritical was 22.1 +/- 1.1 mmHg. These values were not significantly different from the control Kf and PCcritical (0.036 +/- 0.006 and 22.5 +/- 2.3, respectively). After alloxan, Kf (1.43 +/- 0.69) was larger and PCcritical (12.4 +/- 1.3) was significantly less than control (P less than 0.05). Histamine caused no significant change in QL or CL; however, both were increased after alloxan. These results show that Kf, PCcritical, QL, and CL are all changed by an increase in capillary membrane permeability caused by alloxan. Because none of these factors as significantly affected by histamine, dog lung capillary membrane permeability may not be affected by histamine.

Alloxan↗

Errors in calculated oncotic pressure of dog plasma.

Several equations to calculate plasma oncotic pressure (pi) from the total protein concentration (C) have been previously described. These equations were derived empirically from samples with a wide range of C obtained by diluting or concentrating normal plasma samples. To test these equations over a range of naturally occurring C, we measured C and pi of plasma samples from 40 dogs. C ranged from 5.3 to 8.7 g/dl and averaged 6.5 +/- 0.1 (mean +/- SE) and pi averaged 17.9 +/- 0.3 mmHg. The regression equation was pi = 78.14 + 1.67 C (r = 0.74). pi increased with C much less than predicted with the commonly used equations. The albumin-to-globulin concentration ratios (A/G), determined in 27 of the dogs, decreased with increasing C (A/G = 1.56-0.128 C, r = 0.62). The lower A/G at the higher C's could cause the lower than predicted increase in pi with C, because the equations were developed from data in which A/G was constant.

Animals↗

Comparison of microvascular filtration characteristics in isolated and intact lungs.

To determine whether the microvascular membrane of isolated perfused dog lungs is damaged by the isolation procedure, we compared the filtration coefficient (Kf,c) and minimum capillary pressure (Pcc) required to cause continuous edema formation in 10 intact and 8 isolated dog lower left lobes. We used the same gravimetric technique to measure Kf,c and Pcc in both preparations. The Kf,c averaged 0.09 +/- 0.03 (SD) ml . min-1 . Torr-1 . 100 g-1 in the intact and 0.30 +/- 0.16 in the isolated lobes; Pcc averaged 20.1 +/- 4.7 and 1.7 +/- 3.6 Torr in the intact and isolated lobes, respectively. Both Pcc and Kf,c were significantly different in the two preparations (P less than 0.01). These data indicate that the increased tendency of isolated lungs to become edematous at lower pressures may be caused by damage to the microvascular membranes.

Animals↗

Pulmonary capillary pressure and permeability.

An appreciation of the "state of the art" of pulmonary capillary pressure and permeability must necessarily form an important part of the basis of a rational choice of fluid therapy. The present state of the understanding of pulmonary transcapillary fluid exchange is developed. Laboratory data are used in conjunction with clinical evidence to construct and support the physiological concepts set forth.

Capillary Permeability↗

Pulmonary capillary pressure in intact dog lungs.

We used a gravimetric method to determine the ratio (gamma) of pulmonary venous to total pulmonary vascular resistance in intact dog lungs. From this ratio, pulmonary capillary pressure (Pc) can be calculated. The average value of gamma was 0.50 +/- 0.06 (mean +/- SD) in 10 dogs. We found no correlation between gamma and PO2, PCO2, pH, or hematocrit in the narrow ranges of these experiments. Over the capillary pressure range of 22.4--35.2 mmHg we found no correlation between gamma and Pc. The value of gamma found in this study is not significantly different from the value found in isolated perfused lungs.

Animals↗