Effect of positive-pressure ventilatory frequency on regional pleural pressure

Novak, R and Matuschak, GM and Pinsky, MR (1988) Effect of positive-pressure ventilatory frequency on regional pleural pressure. Journal of Applied Physiology, 65 (3). 1314 - 1323. ISSN 0161-7567

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Abstract

Regional lung ventilation is modulated by the spatiotemporal distribution of alveolar distending forces. During positive-pressure ventilation, regional transmission of airway pressure (Paw) to the pleural surface may vary with ventilatory frequency (f), thus changing interregional airflow distribution. Pendelluft phenomena may result owing to selective regional hyperventilation or phase differences in alveolar distension. To define the effects of f on regional alveolar distension during positive-pressure ventilation, we compared regional pleural pressure (Ppl) swings from expiration to inspiration (ΔPpl) and end-expiratory Ppl over the f range 0-150 min-1in anesthetized, paralyzed, close-chested dogs with normal lungs. We inserted six pleural balloon catheters to analyze Ppl distribution along three orthogonal axes of the right hemithorax. Increases in regional Ppl were synchronously coupled with inspiratory increases in Paw regardless of f. However, at a constant tidal volume and percent inspiratory time, end-expiratory Paw and Ppl increased in all regions once a f threshold was reached (P < 0.01). Supradiaphragmatic ΔPpl were less than in other regions (P < 0.05), but thoracoabdominal binding abolished this difference by decreasing thoracoabdominal compliance. We conclude that the distribution of forces determining dynamic regional alveolar distension are temporally synchronous but spatially asymmetric during positive-pressure ventilation at f ≤ 150/min.

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Details

Item Type:	Article
Status:	Published
Creators/Authors:	Creators Email Pitt Username ORCID Novak, R Matuschak, GM Pinsky, MR pinsky@pitt.edu PINSKY
Date:	1 January 1988
Date Type:	Publication
Journal or Publication Title:	Journal of Applied Physiology
Volume:	65
Number:	3
Page Range:	1314 - 1323
Schools and Programs:	School of Medicine > Critical Care Medicine
Refereed:	Yes
ISSN:	0161-7567
Date Deposited:	24 Feb 2012 16:14
Last Modified:	04 Feb 2019 15:57
URI:	http://d-scholarship.pitt.edu/id/eprint/11031

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