Update 1988 pp 227-237 | Cite as
Pulmonary Gas Exchange in Pulmonary Vascular Obstruction
Abstract
Abnormal arterial blood gases are an invariable consequence of both acute and chronic pulmonary vascular obstruction regardless of the etiology. In diffuse lung diseases in which the pulmonary vessels are involved as part of an underlying parenchymal process it is very difficult to separate out the contribution to abnormal pulmonary gas exchange made by the vascular involvement. These would include the pulmonary occlusion seen in the adult respiratory distress syndrome (ARDS), the pulmonary hypertension which results from chronic hypoxic vasoconstriction typified by patients with chronic obstructive pulmonary disease and the vascular obliteration secondary to diffuse interstitial fibrosis. For this reason we will confine ourselves in this discussion to entities, both acute and chronic, in which involvement of the vessels predominate and thus in which the contribution of vascular obstruction is clear.
Keywords
Acute Pulmonary Embolism Primary Pulmonary Hypertension Lung Unit Diffuse Lung Disease Hypoxic VasoconstrictionPreview
Unable to display preview. Download preview PDF.
References
- 1.Dantzker DR, Bower JS (1982) Alterations in gas exchange following pulmonary thromboembolism. Chest 81:495–501.PubMedCrossRefGoogle Scholar
- 2.McIntyre KM, Sasahara AA (1973) Determinants of the cardiovascular response pulmonary embolism. In: Moser K, Stein M (eds) Pulmonary Thromboembolism. Chicago, Year Book Medical Publishers.Google Scholar
- 3.Wagner PD, Saltzman HA, West JB (1974) Measurement of continuous distributions of ventilation-perfusion ratios: Theory. J Appl Physiol 36:588–599.PubMedGoogle Scholar
- 4.Caldini P (1965) Pulmonary hemodynamics and arterial oxygen saturation in pulmonary embolism. J Appl Physiol 20:184–190.Google Scholar
- 5.Johnson A, Malik AB (1981) Effects of different-size microemboli on lung fluid and protein exchange. J Appl Physiol 51:461–464.PubMedGoogle Scholar
- 6.D’Alonzo GE, Bower JS, DeHart P, Dantzker DR (1983) The mechanisms of abnormal gas exchange in acute massive pulmonary embolism. Am Rev Respir Dis 128:170–172.PubMedGoogle Scholar
- 7.Manier G, Castaing Y, Guenard H (1985) Determinants of hypoxemia during the acute phase of pulmonary embolism in humans. Am Rev Respir Dis 132:332–338.PubMedGoogle Scholar
- 8.Huet Y, Lemaire F, Brun-Buisson C, et al (1985) Hypoxemia in acute pulmonary embolism. Chest: 88:829–836.PubMedCrossRefGoogle Scholar
- 9.Young I, Mazzone RW, Wagner PD (1980) Identification of functional lung unit in the dog by graded vascular embolization. J Appl Physiol 49:132–141.PubMedGoogle Scholar
- 10.Malik AB, Van der Zee H (1978) Mechanism of pulmonary edema induced by microembolization in dogs. Circ Res 42:72–79.Google Scholar
- 11.Dantzker DR, Wagner PD, Tornabene VW, Alazraki NP, West JB (1978) Gas exchange after pulmonary thromboembolization in dogs. Circ Res 42:92–103.PubMedGoogle Scholar
- 12.Manier G, Castaing Y, Guenard H (1986) Cardiac output adjustment to hypoxemia during pulmonary embolism. Am Rev Respir Dis 133:A223.Google Scholar
- 13.West JB (1977) Ventilation-perfusion relationships. Am Rev Respir Dis 116:919–943.PubMedGoogle Scholar
- 14.Dantzker DR, Bower JS (1979) Mechanisms of gas exchange abnormally in patients with chronic obliterative pulmonary vascular disease. J Clin Invest 64:1050–1055.PubMedCrossRefGoogle Scholar
- 15.Dantzker DR, Bower JS (1981) Pulmonary vascular tone improves VA/Q matching in obliterative pulmonary hypertension. J Appl Physiol: Respirat Environ Exercise Physiol 51:607–613.Google Scholar
- 16.Dantzker DR, D’Alonzo GE, Bower JS, Popet K, Crevey BJ (1984) Pulmonary gas exchange during exercise in patients with chronic obliterative pulmonary hypertension. Am Rev Respir Dis 130:412–416.PubMedGoogle Scholar
- 17.D’Alonzo GE, Gianotti LA, Pohil RL, et al (1987) Comparison of progressive exercise performance of normal subjects and patients with primary pulmonary hypertension. Chest 92:57–62.PubMedCrossRefGoogle Scholar
- 18.Oren A, Wasserman K, Davis JA, Whipp BJ (1981) Effect of CO2 set point on ventilatory response to exercise. J Appl Physiol 51:185–189.PubMedGoogle Scholar