Abstract
The regulation of the distribution of ventilation/perfusion ratios by hypoxic pulmonary vasoconstriction contributes to both the efficiency of gas exchange and to pulmonary hemodynamics. In this review, the first of a two part series, are summarized the physiologic principles on which the analysis of ventilation/perfusion ratios and of pressure — flow relationships are based. A new combined analysis is introduced that permits the important contributions of hypoxic pulmonary vasoconstriction to overall gas exchange to be demonstrated in the circumstances of clinical complexity.
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References
Fenn WO, Rahn H, Otis AB (1946) A theoretical study of the composition of alveolar air at altitude. Am J Physiol 146:637–653
Riley RL, Cournand A (1949) Ideal alveolar air and the analysis of ventilation-perfusion relationship in the lungs. J Appl Physiol 1:825–847
Farhi LE, Yokoyama T (1967) Effects of ventilation-perfusion inequality on elimination of inert gases. Respir Physiol 3:12–20
Wagner PD, Saltzman HA, West JB (1974) Measurement of continuous distribution of ventilation-perfusion ratios: theory. J Appl Physiol 36:588–599
Hlastala MP (1984) Multiple inert gas elimination technique. J Appl Physiol 56:1–7
West JB (1965) In: Ventilation/blood flow and gas exchange, 1st edn. Blackwell, Oxford
Kelman GR (1966) Digital computer subroutines for the conversion of oxygen tension into saturation. J Appl Physiol 21:1375–1376
West JB, Wagner PD (1977) Pulmonary gas exchange. In: West JB (ed) Bioengineering aspects of the lung. Dekker, New York, pp 361–457
West JB, Wagner PD (1991) Ventilation-perfusion relationship. In: Crystal RG, West JB (eds) The lung: scientific foundations, vol 1. Raven Press, New York, pp 1289–1306
Burton AC (1972) In: Physiology and biophysics of the circulation. Year Book Medical Publishers, Chicago, pp 71–75
Permutt S, Bromberger-Barnea B, Bane HN (1962) Alveolar pressure, pulmonary venous pressure and the vascular waterfall. Med Thorac 19:239–260
Mitzner W (1983) Resistance of the pulmonary circulation. Clin Chest Med 4:127–137
Fung YC (1984) Biodynamics. In: Circulation. Springer, New York, pp 290–364
Marshall BE, Marshall C (1988) A model for hypoxic constriction of the pulmonary circulation. J Appl Physiol 64:68–77
Nelin LD, Krenz GS, Rickaby DA, Linehan JH, Dawson CA (1993) A distensible model applied to hypoxic pulmonary vasoconstriction in the neonatal pig. J Appl Physiol 74:2049–2056
Mitzner W, Chang HK (1989) Hemodynamics of the pulmonary circulation. In: Chang HK, Pavia M (eds) Respiratory physiology. Dekker, New York, pp 561–624
Voelkel NF (1986) Mechanisms of hypoxic pulmonary vasoconstriction. Am Rev Respir Dis 133:1186–1195
Cutaia M, Rounds S (1990) Hypoxic pulmonary vasoconstriction. Chest 93:707–718
Marshall C, Marshall BE (1983) Site and senstivity for stimulation of hypoxic pulmonary vasoconstriction. J Appl Physiol 55: 711–716
Bergofsky EH, Haas F, Porcelli R (1968) Determination of the sensitive vascular sites from which hypoxia and hypercapnia elicit rises in pulmonary arterial pressure. Fed Proc 27:1420–1425
Murray TR, Chen L, Marshall BE, Macarek EJ (1990) Hypoxic contraction of cultured pulmonary vascular smooth muscle cells. Am J Respir Cell Mol Biol 3:457–465
Madden JA, Vadula MS, Kurup VP (1992) Effects of hypoxia and other vasoactive agents on pulmonary and cerebral artery smooth muscle cells. Am J Physiol 263:L384–393
Heistad DD, Armstrong ML, Amundson S (1986) Blood flow through vasa vasorum in arteries and veins: effects of luminal pressures. Am J Physiol 250:H434-H442
Marshall BE, Marshall C, Magno M, Lilagan P, Pietra GG (1991) Influence of bronchial arterial PO 2 on pulmonary vascular resistance. J Appl Physiol 70:405–415
Levitsky MG, Newell JC, Dutton RE (1978) Effect of chemoreceptor denervation with pulmonary vascular responses to atelectasis. Respir Physiol 35:43–51
Marshall BE, Marshall C (1980) Continuity of response to hypoxic pulmonary vasoconstriction. J Appl Physiol 49:189–196
Benumof JL, Wahrenbrock EA (1975) Blunted hypoxic pulmonary vasoconstriction by increased lung vascular pressures. J Appl Physiol 38:846–850
Cheney FW, Bishop MJ, Eisenstein BL, Artman LD (1987) Hypoxic pulmonary vasoconstriction does not affect hydrostatic pulmonary edema formation. J Appl Physiol 62:776–780
Marshall BE, Marshall C, Benumof J, Saidman LR (1981) Hypoxic pulmonary vasoconstriction: effects of lung segment size and alveolar oxygen tension. J Appl Physiol 51:1543–1551
Scanlon TS, Benumof JL, Wahrenbrock EA, Nelson WL (1978) Hypoxic pulmonary vasoconstriction and the ratio of hypoxic lung to perfused normoxic lung. Anesthesiology 49:177–181
Cheney FW, Colley PS (1980) The effect of cardiac output on arterial blood oxygenation. Anesthesiology 52:496–503
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Supported in part by grant # GM29628 from the Institute of General Medical Sciences of the NIH
Correspondence to: Center for Anesthesia Research, 781 Dulles, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
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Marshall, B.E., Marshall, C., Frasch, F. et al. Role of hypoxic pulmonary vasoconstriction in pulmonary gas exchange and blood flow distribution. Intensive Care Med 20, 291–297 (1994). https://doi.org/10.1007/BF01708968
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DOI: https://doi.org/10.1007/BF01708968