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Biomedical subjects

C Saunier

Publications and source records attributed to C Saunier.

At least 19 recordsLinked to original sources

Changes in peripheral pulmonary vascular resistance after ioxaglate infusion in anesthetized dogs.

The pulmonary vascular resistance in a peripheral portion of the pulmonary vascular bed can be determined with a catheter wedged in a peripheral branch of the pulmonary artery, from the pressure increase induced by infusion of mixed venous blood at known flow rates. The volume of the wedged vascular bed can be estimated during fluoroscopy, from the volume of a contrast agent infused until the corresponding pulmonary vein can be seen. The present work was undertaken to determine the possible influence of this maneuver on the peripheral pulmonary vascular resistance (PPVR). In anesthetized dogs, after a control flow run, Hexabrix (meglumine ioxaglate and sodium ioxaglate) was infused, then the catheter was flushed with saline, and another flow run was performed. There was no significant difference between two consecutive control runs in the same site (n = 14). Before Hexabrix (n = 23), PPVR was 162 (+/-24) x 10(3) dyn.s.cm-5 (1 dyn = 10 microN) during the control run; it increased to 339 (+/-33) x 10(3) dyn.s.cm-5 after Hexabrix (p < 0.001). These results show that care should be taken to avoid interference between Hexabrix and the results of physiological or pharmacological interventions with this technique.

Animals

Expiratory flow limitation during mechanical ventilation detected by the forced oscillation method.

We have previously observed large phasic variations of respiratory mechanical impedance in chronic obstructive pulmonary disease (COPD) patients mechanically-ventilated for acute respiratory failure, and postulated that they were due to expiratory flow limitation (EFL). The aim of this study was to test that assumption experimentally and to assess the value of impedance for automatic and noninvasive detection of EFL during mechanical ventilation. The study was performed: 1) in a mechanical analogue, including a flow-limiting element; and 2) in eight anaesthetized and paralysed rabbits, before and during histamine infusion. In both instances, EFL was obtained by lowering the expiratory pressure, using a computer-controlled ventilator; the absence of flow increase when expiratory pressure was further lowered was taken as evidence of EFL. Impedance was measured by applying 15 Hz oscillations at the airway opening. Its real (Re) and imaginary (Im) parts were measured separately during the inspiratory and the expiratory phases, and their differences were related to the mean inspiratory modulus. With the analogue, EFL was accompanied by large decreases both of Re and Im during the expiratory phase. In the rabbits, phasic variations of Re were variable in sign and were not significantly different with and without EFL. In contrast, EFL systematically and specifically decreased Im during the expiratory phase. A threshold of -50% provided a sensitivity of 96% and a specificity of 100% for detecting EFL. The observed phasic variations may be explained by airway wall shunt properties. The study suggests that a large decrease of the imaginary part of impedance during the expiratory phase is a sensitive and specific index of expiratory flow limitation during artificial ventilation.

Animals

Analysis of low-frequency lung impedance in rabbits with nonlinear models.

Lung mechanics was studied in six paralyzed tracheotomized rabbits ventilated with a specially devised computer-controlled ventilator. The target flow waveform contained noninteger multiple frequencies ranging from 0.83 to 6-10 Hz and met a neither-sum-nor-difference criterion to minimize the effects of nonlinearity (B. Suki and K. Lutchen. IEEE Trans. Biomed. Eng. 39: 1142-1151, 1992). The actual flow, however, contained harmonics of the two lowest frequencies. Measurements were performed at mean airway pressure (Paw) levels of 8 and 12 hPa and during histamine-induced bronchoconstriction. Smooth impedance curves were observed in unchallenged rabbits at low mean Paw levels. In contrast, unrealistic impedance fluctuations, suggestive of cross talk from the unwanted frequency components in the flow input, were seen at high mean Paw levels and during acute bronchoconstriction. Model analysis was performed by using the actual flow signal as an input to various nonlinear models. The impedance fluctuations observed at high mean Paw levels were well simulated by a model featuring a volume-dependent elastance, and those observed after histamine were almost perfectly reproduced by a model where resistance increased with the reciprocal of lung volume. We conclude that impedance data biased by cross talk may provide useful information on the presence and nature of respiratory system nonlinearities.

Airway Resistance

Influence of hypoxia and hypercapnia on the kinetics and hypokaliaemic effect of salbutamol in the rabbit.

1. The aims were to document the influence of moderate hypoxia or hypercapnia on salbutamol kinetics and its hypokaliaemic effect, following its administration through the intravenous (60 micrograms/kg), intratracheal (60 micrograms/kg), and oral (2400 micrograms/kg) routes (n = 5). In control animals, PaO2 was around 85 mmHg and PaCO2 20 mmHg; in hypoxic animals PaO2 was around 40 mmHg and in the hypercapnic rabbit PaCO2 was 50 mmHg. 2. Following the intravenous administration of salbutamol, the apparent volume of distribution increased two-fold (p < 0.05) in animals with hypoxia and hypercapnia. Consequently, its half life was enhanced (p < 0.05). Given via the trachea, salbutamol bioavailability was decreased by hypoxia. 3. When salbutamol was given orally, hypoxia or hypercapnia increased the area under salbutamol plasma concentration as a function of time (p < 0.05). 4. In control animals, the salbutamol hypokaliaemic effect was greater when administered orally than through the other routes. Compared with control animals, the experimental conditions reduced the hypokaliaemic effect of salbutamol only when given orally. 5. It is concluded that salbutamol kinetics and dynamics can be altered by hypoxia and hypercapnia.

Administration, Oral

Effect of hypoxia and exercise on the distribution of 65Zn in rat muscles.

The aim of this study was to determine the influence of hypoxia and exercise in 65Zn distribution in various rat muscles. A total of 80 male wistar rats weighting 250 +/- 10 g were randomly separated into eight groups: four groups in air, two at rest, and the other two after exercise; four groups in hypoxia (3 days exposure), two at rest, and the other two after exercise. Two groups (n = 10) in air and two other groups under hypoxia were injected with 65Zn. The 65Zn uptake by blood, pH, and PaO2 decreased significantly during hypoxia. The Zn concentration increased significantly in serum, diaphragm, gastrocnemius, and heart Zn after exercise in air. After hypoxia, at res, Zn increased in serum and in diaphragm. After chronic hypoxia, at rest, radioactivity of 65Zn increased in heart, gastrocnemius, and bone, and it was similar in air condition after exercise with respect to rest. In both cases (air and hypoxia), the uptake of 65Zn by the tissues was higher at rest. After exercise in hypoxia, endogenous Zn decreased in heart and in diaphragm.

Animals

Two-frequency analysis of respiratory mechanics in artificially ventilated rabbits.

The frequency dependence of respiratory mechanical properties was studied in 10 paralyzed, artificially ventilated rabbits, by superimposing a single sinusoidal signal with a frequency of 10, 20 or 30 Hz upon the ventilator waveform. The tracheal pressure and flow signals were analyzed both with the usual first order model, which provided total respiratory elastance (Ers) and resistance (Rrs), and by Fourier analysis, which provided respiratory impedance (Zrs) at the breathing frequency (0.85 Hz) and at the superimposed oscillation frequency. The real part of Zrs (Re(Zrs)) decreased by 30% from 0.85 to 10 Hz (P < 0.001), but did not vary significantly from 10 to 30 Hz. This finding is satisfactorily explained by tissue viscoelasticity. Following a histamine aerosol, the frequency dependence of Re(Zrs) changed very little in three out of four rabbits, but increased substantially in the fourth. In that instance, assuming that lung hysteresivity was not markedly modified by histamine, the results suggest inhomogeneous airway obstruction and/or airway wall shunting.

Airway Resistance

Small-amplitude pressure oscillations do not modify respiratory mechanics in rabbits.

Changes in respiratory mechanics have occasionally been observed during high-frequency ventilation. In this study we investigated whether small pressure oscillations such as those used for respiratory impedance measurements modified total respiratory resistance (Rrs) and total respiratory elastance (Ers). The latter were measured in six paralyzed artificially ventilated rabbits with and without superimposed pressure oscillations at the airway opening. Rrs and Ers were obtained by least square fitting of low-pass filtered tracheal pressure and flow to the usual first-order model. Pressure oscillations of 2-4 hPa peak-to-peak at 10, 20, and 30 Hz applied for periods of 10 min had virtually no effect on Ers (changes ranging from -2.5 to 2.6%) and Rrs (0-8.2%). Analysis of variance did not show a significant difference on the pooled data. Pressure oscillations were also applied every other minute after a histamine aerosol. Ers and Rrs were similarly unchanged. We conclude that the small pressure oscillations used in respiratory impedance measurements do not modify lung mechanical properties and lung response to bronchomotor agents.

Air Pressure

Influence of chronic hypoxia on salbutamol tissular concentrations and on respiratory resistance in anesthetized rabbits.

Salbutamol is a potent beta 2-adrenoceptor agonist given to patients with bronchial asthma who are frequently hypoxemic. The aims of this study were to document the influence of chronic hypoxia on salbutamol tissue concentrations and on salbutamol effect on total respiratory resistance. To this purpose, salbutamol (60 micrograms/kg) was administered intravenously to four groups of six rabbits exposed to four experimental conditions: (1) control rabbits breathing air, (2) histamine-induced bronchoconstriction in rabbits breathing air, (3) animals with chronic hypoxia, (4) histamine-induced bronchoconstriction in animals with chronic hypoxia. The area under salbutamol plasma concentration time curve (0 to 45 min) was not affected by these experimental conditions. Compared with control rabbits breathing air, following histamine-induced bronchoconstriction, salbutamol concentrations rose by 40 to 50% in lung and heart (p < 0.05). Hypoxia did not affect salbutamol distribution in these organs; however, in hypoxic animals, histamine-induced bronchoconstriction increased salbutamol concentrations only in the heart (p < 0.05), without affecting those in the lung. Compared with rabbits breathing air and with histamine-induced bronchoconstriction, the effect of salbutamol was reduced in rabbits under chronic hypoxia and histamine-induced bronchoconstriction (p < 0.05). We conclude that chronic hypoxia reduces salbutamol effect on pulmonary resistance, possibly by decreasing salbutamol lung concentrations.

Airway Resistance

Fourier analysis versus multiple linear regression to analyse pressure-flow data during artificial ventilation.

Respiratory resistance (Rrs) and elastance (Ers) are commonly measured in artificially-ventilated patients or animals by multiple linear regression of airway opening pressure (Pao) versus flow (V') and volume (V), according to the first order model: Pao = P0 + Ers.V + Rrs.V', where P0 is the static recoil pressure at end-expiration. An alternative way to obtain Rrs and Ers is to derive them from the Fourier coefficients of Pao and V' at the breathing frequency. A potential advantage of the second approach over the first is that it should be insensitive to a zero offset on V' and to the corresponding volume drift. The two methods were assessed comparatively in six tracheotomized, paralysed and artificially ventilated rabbits with and without adding to V' an offset equal to 5% of the mean unsigned flow. The 5% flow offset did not modify the results of Fourier analysis, but increased Rrs and Ers from linear regression by 15.8 +/- 4.6% and 4.55 +/- 0.64%, respectively. Without additional offset, differences between the two methods averaged 30.2 +/- 14.0% for Rrs and 9.3 +/- 6.2% for Ers. The differences almost completely disappeared (2.47 and 0.61%, respectively) when the flow signal was zero-corrected using the assumption that inspired and expired volumes were the same. After induced bronchoconstriction, however, Ers was still slightly larger by linear regression than by Fourier analysis, which may result from nonlinearities and/or frequency dependence of the parameters. We conclude that the regression method requires zero flow correction and that Fourier analysis is an attractive alternative.

Algorithms

Muscarinic effect of atrial natriuretic peptide on rabbit airways.

1. The aim of the present work was to investigate under which circumstances atrial natriuretic peptide (ANP) modulates airway resistance. 2. Of the six groups of rabbits (n = 5) studied, three received an infusion of ANP (80 ng min-1 kg-1 i.v.) for a period of 100 min, while the other three were infused with the vehicle. Before receiving the infusion of ANP or the vehicle, the animals were pretreated with atropine (0.5 mg kg-1 i.v.), propranolol (2 mg kg-1 i.v.) or not pretreated. After 75 min of infusion of ANP, bronchoconstriction was induced by inhalation of histamine. Respiratory resistance (Rrs) was measured before and 3, 5, 10, 15 and 20 min post-histamine challenge. 3. Following 75 min of ANP infusion, plasma ANP concentration increased from 153 +/- 52 (mean +/- s.e.mean) to 1441 +/- 203 pg ml-1 (P < 0.05) without affecting baseline Rrs. Control Rrs values (12.5-20.4 cmH2O l-1 s) were significantly increased following the inhalation of histamine (P < 0.001). By themselves, atropine, propranolol or ANP did not modify the histamine-induced increase in Rrs. However, when the animals were pretreated with atropine, ANP infusion significantly reduced the increase in Rrs induced by histamine (30 +/- 2 vs 51 +/- 6 cmH2O l-1 s; P < 0.05). 4. These data suggest that ANP has an indirect modulating effect on the airway smooth muscle and will decrease Rrs when muscarinic receptors are blocked.

Airway Resistance

Peripheral pulmonary vascular resistance.

The pressure-flow relationship has been studied in a peripheral portion of the lung vasculature in anesthetized dogs with use of a double-lumen catheter wedged in a distal pulmonary artery. One lumen was used to infuse mixed venous blood in the wedged area and the other to measure the corresponding perfusion pressure. Flow ranged from 0 to 9.2 ml/min, and the mean volume of the wedged area (n = 59) was 0.75 +/- 0.05 (SE) ml. In the areas where the distal pulmonary artery was in the same direction as the catheter ("coaxial"), the mean pressure-flow curve showed a negligible gamma-intercept and no significant difference between ascending and descending flow. The slope of the initial part of the ascending limb (peripheral pulmonary vascular resistance) varied from site to site and did not show a significant correlation with the overall pulmonary vascular resistance; it was inversely correlated with the volume of the wedged area (r = -0.35, P < 0.05) and directly, as expected, correlated with the y-intercept (r = 0.78, P < 0.001) and hysteresis (r = 0.48, P < 0.001). The results of two consecutive pressure-flow runs in the same site showed similar results, with no difference exceeding the error of measurement. In contrast, the slope increased by 71% during hypoxia (fraction of inspired O2 was 0.10, n = 5). This procedure seems suitable to determine the effects of physiological or pharmacological interventions on the pulmonary vessels, without interference of the systemic circulation.

Animals

Effect of acute and chronic moderate hypoxia on diltiazem kinetics and metabolism in the dog.

The aim of this study was to assess whether moderate hypoxia affects the disposition of diltiazem. Six male beagle dogs received diltiazem (0.6 mg/kg) on three occasions: (1) while breathing air, i.e. during normoxia; (2) 1 h after initiating exposure to a FiO2 of 0.08, a FiCO2 of 0.035 and a FiN2 of 0.885, i.e. during acute hypoxia and normocapnia, and (3) during chronic hypoxia, i.e. after 120 h of exposure to a FiO2 of 0.08. Multiple blood samples were withdrawn and urine was collected to assay diltiazem and metabolites [N-desmethyl diltiazem (MA), deacetyl diltiazem (DAD) and N-desmethyl deacetyl diltiazem (M2)]. Breathing air, mean arterial partial pressure of oxygen was 83.2 +/- 3.2; during acute hypoxia 42.2 +/- 0.7; and during chronic hypoxia, 41.9 +/- 0.6 mm Hg. Acute hypoxia did not alter diltiazem disposition. Compared to dogs with normoxia, chronic hypoxia reduced diltiazem metabolic clearance, from 64 +/- 3 to 51 +/- 5 ml/min/kg (p < 0.05), as well as its volume of distribution, from 11.4 +/- 1.2 to 9.1 +/- 0.3 liters/kg (p < 0.05). Chronic hypoxia decreased the fraction of diltiazem metabolic clearance, normalized by the glomerular filtration rate, generating the M2 metabolite, although this experimental condition did not affect the formation of MA or DAD. It is concluded that chronic moderate hypoxia reduced diltiazem systemic clearance because it decreased selected pathways of biotransformation.

Acute Disease

Effect of acute and chronic moderate hypoxia on the kinetics of lidocaine and its metabolites and on regional blood flow.

The effect of acute and chronic hypoxia on the disposition of lidocaine and its metabolites, and on regional blood flow has been examined in conscious beagles (n = 5). Each dog received an infusion of lidocaine for 5 h under three experimental conditions: (1) breathing air; (2) following acute exposure to a FIO2 of 8% and a FICO2 of 3.5% to generate a PaO2 of 45 mmHg without hypocapnia; and (3) after 6 days of hypoxemia. Multiple blood samples were drawn to assess the kinetics of lidocaine and its metabolites, monoethylglycinexylidide (MEGX) and glycinexylidide (GX). Three hours after the end of the infusion of lidocaine, the dogs received radioactive microspheres to estimate hepatic, renal and brain blood flow. Neither acute nor chronic moderate hypoxia affected the kinetics of lidocaine, the parent compound. However, both experimental conditions increased plasma concentrations of MEGX and GX and increased the ratio of the area under their plasma concentration curves to the dose of lidocaine received. Acute moderate hypoxia increased brain blood flow, although it did not affect liver or renal perfusion. Chronic moderate hypoxia did not significantly change the blood flow to any of the organs studied. It was concluded that acute and chronic moderate hypoxia decreases the rate of elimination of both active metabolites of lidocaine without modifying the perfusion to the organs responsible for their elimination.

Animals

Pressure/flow relation in the peripheral pulmonary vascular bed in dogs: a preliminary study.

In order to test a technique for the determination of the pressure/flow relationship in the peripheral pulmonary vascular bed, the perfusion pressure changes with increasing and then decreasing flow in a small part of the lung (around 1 ml) were studied in anaesthetized supine dogs, after insertion of a specially designed double distal lumen Swan-Ganz catheter. One lumen was used for the pressure measurement, one for infusion of saline by a pump with variable flow, from 0.1 to 1.0 ml s-1. A conventional thermodilution Swan-Ganz catheter was also advanced in the pulmonary artery, to measure pressures in the pulmonary circulation as well as cardiac output. During infusion in the wedged catheter, right atrial, pulmonary arterial and balloon occlusion wedge pressures did not change. The pressure/flow curve of the occluded vascular bed showed a shape similar to that of collapsible tubes, with a pressure plateau at high flow, but this could also be due to vascular recruitment. The curve exhibited hysteresis, with a lower pressure when flow decreased. The slope of the initial part of the curve increased, on average, from 54 +/- 9 during normoxia to 91 +/- 27 mmHg s ml-1 during hypoxia (FIO2 = 0.10); this difference was not significant, but the perfusion pressure at high flow was significantly higher during hypoxia (P less than 0.05). Using blood instead of saline would allow the determination of the peripheral pulmonary vascular resistance under physiological conditions, and further work is needed to estimate the sensitivity and the reproducibility of this technique.

Animals

Effects of cilazapril, a novel angiotensin converting enzyme inhibitor, on the structure of pulmonary arteries of rats exposed to chronic hypoxia.

Chronic hypoxia is known to be associated with a thickening of the media of pulmonary arteries. The goal of the present study was to assess if cilazapril, a novel long-acting angiotensin converting enzyme (ACE) inhibitor, could prevent this thickening. For this purpose, three groups of rats were studied. One group was kept in normal room air. Two other groups were exposed to chronic hypoxia (inspired fraction of oxygen equal to 8% during 4 weeks). One group of hypoxic rats was treated with placebo and the other group received cilazapril (as food admixture of approximately 3 mg/kg/day). After 4 weeks, rats were anesthetized and pulmonary artery pressure and hematocrit measured. Then, the lungs were perfused and fixed and morphometry of the pulmonary arteries was performed. Hypoxia induced an increase in pulmonary artery pressure and hematocrit associated with a dramatic increase in the thickness of the media of the pulmonary arteries. Cilazapril completely prevented the thickening of the media of the pulmonary arteries but did not significantly decrease the pulmonary artery pressure or right ventricular weight.

Angiotensin-Converting Enzyme Inhibitors

Preserved CO2 response in cerebral and muscular blood vessels during cimetidine treatment.

It is known that cimetidine inhibits the hypoxia-induced increase in cerebral blood flow (CFB) in dogs, but the mechanism of this inhibition is not fully understood. Since the accepted mechanisms explaining the increase in CBF during hypercapnia are very different from those active during hypoxia, acute hypercapnia was induced in 12 conscious dogs in order to study the cimetidine effect in this condition. Six dogs were given i.v. saline (control group) and the other six, i.v. cimetidine (4 mg kg-1). After 15 min, CBF and various muscular blood flow measurements were performed, using the microspheres technique under two conditions: (1) breathing air and (2) after 2 h inhalation of a gas mixture with FiCO2 0.10, FiO2 0.21 in nitrogen. The CBF increase was similar in both series with or without cimetidine. The changes in muscular blood flow were unaffected by the H2-blocker. We conclude that cimetidine has no effect on the CBF and on muscular blood flow during acute hypercapnia.

Animals

Effects of H2-receptor blockers on response of cerebral blood flow to normocapnic hypoxia.

Cimetidine blunts the increase in cerebral blood flow (CBF) normally observed during hypoxia. It is important, therefore, to know whether other H2-blockers also affect the cerebral circulation adaptation to hypoxia. Cerebral blood flow was measured in 24 awake dogs after an intravenous injection of either saline (control) or one of three H2-blockers: 1 mg/kg ranitidine, 0.4 mg/kg famotidine, or 1 mg/kg roxatidine. These doses are equipotent blockers of H2-gastric receptors. Each dog was studied during normoxia and after 2 and 4 h of normocapnic hypoxia (FIO2, 0.10; FICO2, 0.035). During each set of experimental conditions, a bolus of either saline or one of the anti-H2 drugs was administered, and, 15 min later, radiolabeled microspheres (ruthenium 103, scandium 46, and cerium 141) were injected into the left atrium for measurement of regional CBF. After death by an overdose of thiopental, each dog's brain was excised and fixed in 10% formaldehyde; it was then weighed and dissected by region, with the radioactivity measured in each region using a gamma counter. During hypoxia, PaO2 ranged from 45 to 50 mm Hg, and pH, PaCO2, and hematocrit were within the normal limits. In the control group CBF increased 34% above normoxic baseline levels after 2 h and 31% after 4 h of hypoxia. Ranitidine (1 mg/kg) did not prevent the increase in CBF during hypoxia, but famotidine and roxatidine prevented it. When the dose of ranitidine was doubled (2 mg/kg), it too abolished the increase of CBF induced by hypoxia. In conclusion, H2-receptor blockers could interfere with the adaptation of CBF during hypoxia.

Animals

Prevalence of antibodies to HTLV-1 in South American Indians (Mapuches) from Chile.

The seroprevalence of HTLV-1 antibodies was investigated in 405 serum samples from healthy South American Indians (Mapuches) from Chile, using enzyme linked immunoassay (ELISA), Western immunoblot (WB) and radioimmuno precipitation assay (RIPA). Six samples were positive by ELISA; 3 of them were confirmed by WB/RIPA. Thus, we observed a seroprevalence of 0.7% for HTLV-1 antibodies in healthy Mapuches.

Blotting, Western