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At least 19 recordsLinked to original sources

[Mass spectrum analysis of expired and alveolar gas during separate bronchospirometry].

It is possible to measure with a mass spectrometer the oxygen and carbon dioxide pressure in expired gas and alveolar gas in each lungs during a separate bronchospirometry. In 15 cases out of 26 (of which 21 had broncho-pulmonary cancers) it was possible to trace serious disorders of the alveolar-capillary exchanges in the diseased lung, probably related to an altered ventilation-perfusion relationship. This technique brings more data to the physio-pathologist than the plain measurement of the oxygen consumption of the diseased lung.

Bronchial Neoplasms

Chest physiotherapy and the distribution of ventilation.

The injured or postoperative thorax is commonly treated with physiotherapy employing "unilateral breathing" techniques. The ability of these methods to alter the distribution of ventilation and blood flow (oxygen uptake) was examined in four patients undergoing bronchospirometry. No change was observed in these measurements in the lung toward which efforts were being directed to either enhance or restrict the mechanics of breathing. To further examine the problem, two susceptible subjects were hypnotized following intubation for bronchospirometry, and emotional and physical states were suggested that limit motion in one hemithorax. This included the presence of pleuritic pain in one subject who had ample experience with this symptom. In no instance did we find a change in the distribution of ventilation or blood flow to the lung that was supposed to be limited; however, in 17 subjects, lying on one side produced a significant increase in ventilation and blood flow in the dependent lung. Lying on one side or the other consistently and predictably modified ventilation and blood flow, while attempts to produce similar changes by voluntary intention or commonly applied mechanical aids were ineffective.

Breathing Exercises

Capnography does not reliably detect double-lumen endotracheal tube malplacement.

Two patients are described in whom double-lumen endotracheal tube malplacement and its ventilatory consequences were not detected by infrared capnography. Problems were suspected on auscultation, and the malplacement was diagnosed by means of bronchospirometry. We conclude that bronchospirometry helps detect problems with endotracheal intubation.

Carbon Dioxide

A comparative study of the effects of dry vs. humidified ventilation on canine lungs.

To compare the effects on canine ciliary and bronchial mucosal function of varying periods of ventilation with dry vs. humidified gas mixtures, 29 anesthetized dogs underwent 2, 4, and 6 hours of ventilation through a Carlen's double-lumen tube. Six dogs were evaluated by clearance studies, nine by differential bronchospirometry, six by surfactant studies, six by electron microscopy, and two by ventilation scanning. By means of two separate respiratory systems, dry gas (DG) was used to ventilate the right lung, and humidified gas (HG) ventilated the left lung in each dog. Serial chest roentgenograms showed more rapid clearance of inspired tantalum dust from the HG-ventilated lung in each of the six dogs, the disparity in clearance between the two lungs being more pronounced after longer periods of ventilation. The surface tension in DG-ventilated lungs increased fourfold, whereas in HG-ventilated lungs it increased only twofold as compared to preoperative values. Longer periods of ventilation did not change the surface tension appreciably in either DG- or HG-ventilated lungs. Scanning electron micrographs of bronchial mucosa from DG-ventilated lungs showed tangling and matting of cilia with a granular and stringy material attached to most cilia; these changes were much less pronounced in HG-ventilated lungs. Bronchospirometric studies showed an increase in ventilatory function in each of the lungs ventilated with the HG mixture (percent Vo2 on 100 percent oxygen increased 27.7 percent) to compensate for the decreased gas exchange provided by the contralateral DG-ventilated lung. Function in each of the lungs returned to normal within 24 hours. Ventilation scans with Xenon133 showed no apparent change in isotope uptake in the HG-ventilated lungs as compared to the DG lungs during the first 24 hours after ventilation. The observations from the present study suggest that ventilation of canine lungs with DG for 4 or more hours dries mucus and transiently retards mucociliary clearance and gas exchange. These changes may be minimized by ventilation with a humidified gas mixture. Application of these findings to patients undergoing prolonged general anesthesia and to lung preservation studies is suggested.

Animals

Terminal nitrogen rise.

Eighteen-breath nitrogen washouts were performed on eight subjects. Each washout could be simulated by a four-compartment model, each compartment with a different ventilation-to-volume ratio and a variable contribution to expiratory flow. In large breaths initiated near residual volume, a terminal nitrogen rise (TNR) was seen. To account for the TNR with this model, there were relatively small changes in flow from compartments with markedly different nitrogen concentration. Reasons are given for believing these compartments could not be the upper and lower lung. Three of these subjects were studied in the supine, seated, and head-down positions. The TNR was seen at the same lung volume in all positions. At routine bronchospirometry in a second group of subjects, sampling with small catheters during a nitrogen washout showed a TNR in the expirate of lungs, lobes, segments, and subsegments in the upright and supine positions. Apparently a large vertical hydrostatic gradient is unnecessary to produce a TNR. Finally, the TNR was shown to occur at that lung volume where transpulmonary pressure is very small and changing rapidly with volume. This TNR was often followed by a terminal nitrogen fall while the lung was continuing to empty. The TNR occurs when flow from a large poorly ventilated compartment increases relative to the flow from other compartments. A model of lung in which the poorly ventilated compartment develops high specific compliance at low lung volume explains these data.

Adult

The effect of granulomatous pulmonary disease in dogs on the response of the pulmonary circulation to hypoxia.

We studied the effect of diffuse granulomatous pulmonary disease on the reponse of the pulmonary circulation to hypoxia in two series of experiments in intact dogs. First, in animals with unilateral disease, vasoconstriction in the diseased lung was compared to that in the contralateral control lung. Second, in animals with bilateral disease, the vasoconstriction of pulmonary shunt pathways was compared to that of the rest of the pulmonary vasculature. We assessed vasoconstriction in each study by measuring the distribution of pulmonary blood flow between the test and control set of vessels during 21 and 12% oxygen breathing. In the first set of experiments, we measured apportionment of the blood flow between the two lungs by bronchospirometry and the krypton bolus method. In normal dogs, hypoxia did not shift blood flow systematically from one lung to the other. In 10 dogs with unilateral disease, general hypoxia increased the proportion of blood flow to the diseased lung. The mean percent of blood flow to the left lung in eight dogs with disease in that lung rose from 29% during air breathing to 32% (P < 0.001). In the second set of experiments, we measured apportionment of the blood flow between shunt pathways and gas-exchanging pathways by a constant infusion of radio-active krypton and the standard shunt formula. In eight dogs with bilateral disease, hypoxia consistently increased the flow through shunt pathways, from a mean value of 10% of pulmonary blood flow to 14% (P < 0.005).Thus, diffuse granulomatous disease causes a decreased vasoconstrictive response to hypoxia both in diseased, gas-exchanging regions and in shunt pathways. In proliferative interstitial pulmonary disease, generalized hypoxia causes shifts in pulmonary blood flow which do not ameliorate but rather worsen the hypoxemia of systemic arterial blood.

Animals

Evaluation before thoracotomy.

When a thoracotomy is being considered, the physician must first determine whether the lesion is potentially resectable. However, an equally important decision is whether the patient can tolerate pulmonary resection if there are other serious underlying medical problems. In any patient with signs or symptoms of pulmonary disease, a spirogram, arterial blood gas study and electrocardiogram should be done as part of the routine preoperative evaluation. The detection of abnormal pulmonary function should prompt preoperative institution of respiratory care to optimize maximally a patient's cardiorespiratory status before operation. If any of several indicators of a high risk of postoperative cardiopulmonary problems are found, split pulmonary function studies should be done to determine whether the lung remaining after resection will have adequate ventilation and perfusion. Xenon radiospirometry is preferable to bronchospirometry and right heart catheterization because of its noninvasiveness. Resection should not be undertaken in the presence of a predicted postoperative forced expiratory volume in one second (FEV(1)) less than 0.8 liter, an arterial carbon dioxide partial pressure (PaCO(2)) greater than 45 mm of mercury or Xenon scans which show poor ventilation/perfusion ( V/ Q) matchup in what would be the remaining lung after resection. A case is reported which shows the value of this approach to preoperative evaluation in determining the risk of postoperative problems.

Adenocarcinoma

[Bronchospirometric and rheographic characteristics of external respiration and hemodynamics of the lesser circulation in purulent lung diseases].

Using bronchospirometry and rheography the external respiration and hemodynamics of the minor circulatory circuit were studied in 164 patients with suppurative processes in the lung. Ventilatory-respiratory indices were found to be reduced in the affected and "healthy" lung. A correlative dependence between the gravity of respiratory disorders and the state of the minor circulation hemodynamics was proved statistically.

Adolescent

[The thoracic radiographic picture in routine monitoring following unilateral allogenic lung transplantation in the dog].

Undesired effects of nonspecific immunosuppression may be delimited by individual dosage. Early recognition of allograft rejection is the presupposition for that steering. As long as immunologic test methods require a great expense of equipment, personnel, and time, and as other methods (bronchospirometry, lung puncture) after lung transplantation additionally endanger the recipient, clinical routine examinations are particularly important, primarly thorax x-ray examinations. The authors report on serial chest radiographs during the courses after 71 unilateral orthotopic allogenic pulmonary transplantations in dogs with regard to the findings at obduction. Possibilities of differential diagnosis shall be found by that, and the limits of interpreting x-ray films after lung transplantation shall be disclosed. Certain distinctive marks in the x-ray findings indicate the various possible complications; they can not be relied upon, however, when they only extend to the graft (hemorrhage, infection, rejection).

Animals

[Lung functions after single-lung homotransplantation in dogs (author's transl)].

Unilateral homotransplantation of the lung was performed in ten healthy mongrel dogs. Assessment of pulmonary function was obtained immediately after transplantation ten days and four weeks postoperatively. A conventional endotracheal tube was used for measurement of total lung function. A special tube was deviced for bronchospirometric measurements in dogs. A moderate increase of tidal volume and marked increase of respiratory rate and minute ventilation could be noted immediately after transplantation. Oxygen consumption was not changed significantly. There was a marked decrease in arterial pO2-level following transplantation, which was improved during the follow-up studies and found within normal limits at the tenth postoperative day. Bronchospirometry immediately following transplantation revealed equal ventilation values of both lungs, but oxygen consumption of the transplant was reduced 50% compared to the recipient's own lung. On the tenth postoperative day ventilatory function of the transplant was found close to that of the recipients own lung. Oxygen consumption in respiratory equivalent at this time averaged two thirds of the animal's own lung. Four weeks following transplantation no further significant change of respiratory function could be noted.

Animals

Patterns of bulbar respiratory neurons during and after artifical hyperventilation.

Single bulbar respiratory unit activity was recorded in urethane-anesthetized rabbits. During artificial ventilation, reflex contractions of the diaphragm were elicited by the forced deflations of the respirator. Out of 44 neurons, four I, one E and two EI units exhibited a shift of their discharge relative to the contractile phase of the diaphragm, compared to normal respiration. During hypocapnic apnea, some I, IE and E neurons became silent. Other cells belonging to all phase types, however, continued to fire tonically at a rate less than the peak rate in normal bursts. When rhythmic respiration resumed after termination of the apneic pause, five (I, IE and E) units exhibited a transient phase shift of their burst discharge compared to normal respiration. The results of simultaneous recordings of two neurons belonging to different phase types are compatible with the assumption that inspiratory units are periodically inhibited by inspiratory-expiratory cells.

Animals

Total rupture of the left main bronchus successfully repaired nine years after injury.

A patient who sustained a traumatic rupture of the left main bronchus that was successfully repaired nine years later is presented, and reference is made to reports of similar instances in which operation has been performed more than five years after injury. Pulmonary function following operation improved progressively and proved the delayed repair to have been a reasonable decision.

Adult