Abstract
The transmission of forces from the respiratory muscles to the lung across the extremely thin pleural space has been poorly understood because of the difficulty of accurately measuring pleural liquid and pleural surface pressure (lung static recoil or transpulmonary pressure). Recent results using relatively noninvasive techniques have indicated that the vertical gradient in pleural liquid pressure is not hydrostatic, that pleural liquid pressure is closely related to lung recoil, and that there exists a very thin but continuous pleural liquid layer. These findings contradict concepts based on hydrostatic equilibrium and on the distinction between pleural liquid and pleural surface pressure due to pleural contact. Pleural liquid pressure is not in hydrostatic equilibrium because the difference between the vertical gradient in pleural liquid pressure and the effect of gravity is always balanced by a pressure loss due to a viscous flow within the pleural space. Fluid lubrication of the pleural surfaces is the primary function of the pleural space. The mechanical interaction between the lung and the chest wall is coupled to the dynamics of liquid within the pleural space, which is viewed as a flow-through system. Homeostasis is achieved in such a system by the adjustment of the viscous flow within the pleural space and the outflow absorption rate by lymphatics to the microvascular filtration rate across pleural capillaries.
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References
Agostoni E (1972) Mechanics of the pleural space. Physiol Rev 52:57–128
Agostoni E, D’Angelo E (1968) The recoil of the most dependent part of the lung. Respir Physiol 5:379–384
Agostoni E, D’Angelo E (1970) Comparative features of the transpulmonary pressure. Respir Physiol 11:76–83
Agostoni E, D’Angelo E, Bonanni MV (1969) Measurements of pleural liquid pressure without cannula. J Appl Physiol 6:245–256
Agostini E, Taglietti A, Setnikar I (1957) Absorption force of the capillaries of the visceral pleural in determination of intrapleural pressure. Am J Physiol 191:277–282
Agostoni E, D’Angelo E, Roncoroni G (1968) The thickness of the pleural liquid. Respir Physiol 5:1–13
Agostoni E, Miserocchi G (1970) Vertical gradient of transpulmonary pressure with active and artificial lung expansion. J Appl Physiol 29:705–712
Agostoni E, Miserocchi G, Bonnani MV (1969) Thickness and pressure of the pleural liquid in some mammals. Respir Physiol 6:245–256
Albertine KH, Weiner-Kronish JP, Bastacky J, Staub NC (1984) The structure of the pleural space in sheep (Abstract). Fed Proc 43:831
Albertine KH, Weiner-Kronish JP, Staub NC (1984) The structure of the parietal pleura and its relationship to pleural liquid dynamics in sheep. Anat Rec 208:401–409
Andrews PM, Porter KR (1973) The ultrastructural morphology and possible functional significance of mesothelial microvilli. Anat Rec 177:409–426
Banchero N, Schwartz PE, Tsakiris AG, Wood EH (1967) Pleural and esophageal pressures in the upright body position. J Appl Physiol 23:228–234
Bar-Yishay E, Hyatt RE, Rodarte JR (1986) Effect of heart weight on distribution of lung surface pressures in dogs. J Appl Physiol 61:712–717
Bohlen HG, Gore RW, Hutchin PM (1977) Comparison of microvascular pressures in normal and spontaneously hypertensive rats. Microvasc Res 13:125–130
Brandi G (1972) Frictional forces at the surface of the lung. Bull Physio-Path Resp 8:323–336
Chevalier PA, Rodarte JR, Harris LD (1978) Regional lung expansion at total lung capacity in intact vs. excised canine lungs. J Appl Physiol 45:363–369
Coulam CM, Wood EH (1971) Regional differences in pleural and esophageal pressures in head-up and head-down positions. J Appl Physiol 31:277–287
Courtice FC, Simmonds WJ (1954) Physiological significance of lymph drainage of the serous cavities and lungs. Physiol Rev 34:419–448
D’Angelo E, Bonanni MV, Michelini S, Agostoni E (1970) Topography of the pleural surface pressure in rabbits and dogs. Respir Physiol 8:204–229
Glazier JB, Hughes JMB, Maloney JE, West JB (1967) Vertical gradient of alveolar size in lungs of dogs frozen intact. J Appl Physiol 23:694–705
Granger DN, Taylor AE (1980) Permeability of intestinal capillaries to endogenous macromolecules. Am J Physiol 238:H457–464
Hajji MA, Wilson TA, Lai-Fook SJ (1979) Improved measurements of shear modulus and pleural membrane tension of the lung. J Appl Physiol 47:175–181
Hills BA, Butler BD, Barrow RE (1982) Boundary lubrication imparted by pleural surfactants and their identification. J Appl Physiol 53:463–469
Hoffman EA, Behrenbeck T, Chevalier PA, Wood EH (1983) Estimation of regional pleural surface expansile forces in intact dog. J Appl Physiol 55:935–948
Hoffman AE, Lai-Fook SJ, Wei JH, Wood EH (1983) Pleural pressures by wick catheters. J Appl Physiol 55:1523–1529
Hoffman EA, Ritman EL (1985) Effect of body orientation on regional lung expansion in dog and sloth. J Appl Physiol 59:481–491
Hogg JC, Nepszy S (1969) Regional lung volume and pleural pressure gradient estimated from lung density in dogs. J Appl Physiol 27:198–203
Hoppin FG, Jr., Green ID, Mead J (1969) Distribution of pleural surface pressure in dogs. J Appl Physiol 27:863–873
Hubmayr RD, Walters BJ, Chevalier PA, Rodarte JR, Olson LE (1983) Topographic distribution of regional lung volume in anesthetized dogs. J Appl Physiol 54:1048–1056
Hyatt RE, Bar-Yishay E, Abel MD (1985) Influence of the heart on the vertical gradient of transpulmonary pressure in dogs. J Appl Physiol 58:52–57
Kaplowitz MR, Lai-Fook SJ (1985) Pressure and dimensions of pleural liquid at lobar margins of dogs and rabbits (Abstract). Fed Proc 44:1027
Kinasewitz GT, Fishman AP (1981) Influence of alterations in Starling forces on visceral pleural fluid movement. J Appl Physiol 51:671–677
Kinasewitz GT, Groome LT, Marshall RP, Diana JN (1983) Permeability of the canine visceral pleural. J Appl Physiol 55:121–130
Kim KJ, Critz A, Crandall E (1979) Transport of water and solute across sheep visceral pleura. Am Rev Respir Dis 120:882–892
Krueger JJ, Bain T, PattersonJL. Elevation gradient of intrathoracic pressure. J Appl Physiol 16:465–468
Lai-Fook SJ, Beck KC, Southorn PA (1984) Pleural liquid pressure measured by micropipettes in rabbits. J Appl Physiol 56:1633–1639
Lai-Fook SJ, Kaplowitz MR (1985) Pleural liquid thickness in situ by light microscopy in five mammalian species. J Appl Physiol 59:603–610
Lai-Fook SJ, Price DC, Staub NC (1987) The relationship between liquid and vertical liquid pressure gradient in a model of the pleural space. J Appl Physiol 62:1747–1754
Lai-Fook SJ, Kaplowitz MR (1986) Protein concentration and thickness of pleural liquid in spontaneously hypertensive rats and normal rats (Abstract). Fed Proc 45:317
McLaughlin RF, Tyler WS, Canada RO (1961) A study of the subgross pulmonary anatomy of various mammals. Am J Anat 108:149–159
McMahon SM, Proctor DF, Permutt S (1969) Pleural surface pressure in dogs. J Appl Physiol 27:881–885
Milic-Emili J, Henderson JAM, Dolovich MB, Trop D, Kaneko K (1966) Regional distribution of inspired gas in the lung. J Appl Physiol 21:749–759
Miserocchi G, Nakamura T, Mariani E, Negrini D (1981) Pleural liquid pressure over the interlobar mediastinal and diaphragmatic surfaces of the lung. Respir Physiol 46:61–69
Miserocchi G, Negrini D, Mariani E, Passafaro M (1983) Reabsorption of saline- or plasma-induced hydrothorax. J Appl Physiol 54:1574–1578
Miserocchi G, Negrini D, Mortola J (1984) Comparative features of Starling-lymphatic interaction at the pleural level in mammals. J Appl Physiol 56:1151–1156
Miserocchi G, Pistolesi M, Miniati M, Bellina CR, Negrini D, Giuntini C (1984) Pleural liquid pressure gradients and intrapleural distribution of injected bolus. J Appl Physiol 56:526–532
Negrini D, Pistolesi M, Miniati M, Bellina R, Giuntini C, Miserocchi G (1985) Regional protein absorption rates from the pleural cavity in dogs. J Appl Physiol 58:2062–2067
Olson LE, Lai-Fook SJ (1986) Pleural liquid pressure measured with rib capsules in ponies (Abstract). Physiologist. 29:124
Patlak CS, Goldstein DA, Hoffman JF (1963) The flow of solute and solvent across a two membrane system. J Theor Bio 5:525–542
Permutt S, Caldini P, Bane H, Howard HP, Riley RL (1967) Liquid pressure versus surface pressure of the esophagous. J Appl Physiol 23:927–933
Proctor DF, Caldini P, Permutt S (1968) The pressure surrounding the lung. Respir Physiol 5:130–144
Rutishauser WJ, Banchero N, Tsakiris AG, Edmundowicz AC, Wood EH (1966) Pleural pressures at dorsal and ventral sites in supine and prone body positions. J Appl Physiol 21:1500–1510
Rutishauser WJ, Banchero N, Tsakiris AG, Wood EH (1967) Effect of gravitational and inertial forces on pleural and esophageal pressures. J Appl Physiol 22:1041–1052
Setnikar I, Agostoni E, Taglietti A (1957) Entita, caratteristiche e origine della depressione pleurica. Arch Sci Biol 41:312–325
Spells KR (1969) Comparative studies in lung mechanics based on a survey of literature data. Resp Physiol 8:37–57
Stahl WR (1967) Scaling of respiratory variables in mammals. J Appl Physiol 22:453–460
Stewart PB, Burgen A (1958) The turnover of fluid in the dog’s pleural cavity. J Lab Clin Med 52:212–230
Surprenant EL, Rodbard S (1963) A hydrostatic pressure gradient in the pleural sac. Am Heart J 66:215–220
Thurlbeck WM, Marshall RM (1973) Topography of esophageal pressure in the dog. J Appl Physiol 34:590–596
West JB, Matthews FL (1972) Stresses, strain, and surface pressures in the lung caused by its weight. J Appl Physiol 32:332–345
Wiederhielm CA, Woodbury JW, Kirk S, Rushmer RF (1964) Pulsatile pressures in the microcirculation of frog’s mesentery. Am J Physiol 207:173–176
Weiner-Kronish JP, Albertine KH, Lichko V, Staub NC (1984) Protein egress and entry rates in pleural liquid and plasma in sheep. J Appl Physiol 56:459–463
Weiner-Kronish JP, Gropper MA, Lai-Fook SJ (1985) Pleural liquid pressure in dogs measured using a rib capsule. J Appl Physiol 59:597–602
Wunder CC, Reed JH Jr., McConahey WM III, Cronin L, Wood EH (1969) Nature of pleural space of dogs. J Appl Physiol 27:637–643
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Lai-Fook, S.J. Mechanics of the pleural space: Fundamental concepts. Lung 165, 249–267 (1987). https://doi.org/10.1007/BF02714442
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DOI: https://doi.org/10.1007/BF02714442