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The role of reflex hypotension in pulmonary embolism

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Zusammenfassung

16 Hunde, bei denen die linke Lunge reseziert und anschließend autotransplantiert worden war, wurden nach Rückkehr normaler Lungenfunktionswerte selektiv von der linken oder der rechten Arteria pulmonalis aus embolisiert. Als Embolisationsmaterial wurden Glasperlen von einem Durchmesser von 50±10 Mikra verwendet. Embolisation der Kontrollunge mit 2 g erzeugte regelmäßig eine Erhöhung des Drucks in der Pulmonalarterie, einen Abfall des femoralen Blutdrucks und Tachypnoe. Embolisation des denervierten Transplantates ergab keine signifikanten Änderungen der Druckwerte im großen und kleinen Kreislauf und beeinflußte auch nicht die Atmung. Eine Verdoppelung der Dosis der Glasperlen war bei einem Teil der Tiere, deren Kontrollunge embolisiert wurde, tödlich. Dieselbe Menge Embolisationsmaterial injiziert in die denervierte Lunge rief eine signifikante Erhöhung des pulmonalen Blutdrucks hervor, wurde jedoch von allen Tieren überlebt. Es wird die Schlußfolgerung gezogen, daß das vegetative Nervensystem eine wichtige Rolle beim Reflexmechanismus der Lungenembolie spielt.

Summary

16 dogs which survived a unilateral lung autografting procedure and regained normal pulmonary function were selectively embolized on the denervated transplant or the control lung. Embolization of the control lung with 2 g of glass microspheres 50±10 micra in diameter gave a typical embolization response with pulmonary hypertension, tachypnea, and systemic hypotension. The denervated lung did not respond to embolization. Doubling the number of glass emboli killed 2 out of 4 dogs embolized on the control lung; the same dose of emboli injected into the denervated lung produced a significant rise of pulmonary artery pressure, but all animals survived. It is concluded that the autonomic nervous system plays a major role as the afferent pathway in the reflex response to pulmonary embolism.

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Authors and Affiliations

  1. School of Medicine, Department of Anaesthesiology, University of Oklahoma, USA

    Walter H. Massion (Associate Professor of Anaesthesiology)

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  1. Walter H. Massion
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Additional information

To Prof. F. Verzár on his 80th birthday.

Work supported by U.S.P.H.S. grant HE 08329.

Recipient, NIH Career Investigator Development Award 5-K3-NB-17,651.

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Massion, W.H. The role of reflex hypotension in pulmonary embolism. Pflügers Archiv 288, 109–117 (1966). https://doi.org/10.1007/BF00362562

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  • DOI: https://doi.org/10.1007/BF00362562

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