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Determinants of pulmonary blood volume. Effects of acute changes in airway pressure
Authors:J Thorvaldson  A Ilebekk  F Kiil
Abstract:To examine the effects of airway pressure (AWP) on pulmonary blood volume (PBV) at various pulmonary vascular pressures and flows, experiments were performed in anaesthetized, open-chest dogs. The AWP was raised by elevating end-expiratory pressure, and PBV was calculated as the product of electromagnetic aortic flow and pulmonary mean transit time for ascorbate (polarographic method). When AWP was raised from 3 to 13 mmHg, changing lung conditions from zone 3 [left atrial pressure (LAP) higher than AWP] to zone 2 (AWP higher than LAP), PBV decreased by 14.5 +/- 6.2%. When LAP was raised above 7 mmHg at constant pulmonary arterial pressure (PAP), PBV increased under zone 2 but not under zone 3 conditions. During blood volume expansion to LAP 15 mmHg, PBV rose by 30-50% and became equal at AWP of 4 and 14 mmHg, whereas the pulmonary vascular resistance remained 40% higher at high AWP. These data suggest that PAP, LAP and AWP regulate PBV by acting on compliant vessels surrounding the alveoli. Under zone 2 conditions with collapsed aveolar capillaries, elevation of LAP results in re-expansion of the alveolar capillaries, and PBV is restored without a rise in PAP. Under zone 3 conditions, a rise in LAP cannot increase PBV without raising PAP, explaining why PBV remains constant when PAP is kept constant.
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