Pulmonary Circulation During Anesthesia

  • B. E. Marshall
  • C. Marshall
Part of the Developments in Critical Care Medicine and Anesthesiology book series (DCCA, volume 25)


The anatomie arrangement and composition of the lung has evolved so as to allow gas exchange across a large and exquisitely thin membrane at the blood/gas interface (1). The entire cardiac output must be accommodated at low pulmonary vascular pressures and this imposes a design constraint that is common to all mammals. The low pressure is necessary to avoid the development of edema. The plasma oncotic pressure is normally about 35 cm H2O and, according to the relationships governing fluid flow enunciated by Starling a century ago, this is also the upper limit for the normal pulmonary artery pressure. Patients with pulmonary artery pressure consistently above 35 cm H2O are diagnosed as having pulmonary hypertension (2). Interestingly in all these species the vital capa city of the lung is achieved with transpulmonary pressures of 35 cm H2O, and barotrauma occurs in otherwise normal lungs ventilated with pressures in excess of this. The pulmonary circulation is therefore a system of elastic tubes in parallel the dimensions of which are governed passively by intravascular and extravascular fore es and by vasoactivity.


Pulmonary Artery Pressure Pulmonary Vascular Resistance Pulmonary Circulation Bronchial Artery Left Atrial Pressure 
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© Springer Science+Business Media Dordrecht 1992

Authors and Affiliations

  • B. E. Marshall
  • C. Marshall

There are no affiliations available

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