PubMed HealthSearch

Biomedical subjects

S S Cassidy

Publications and source records attributed to S S Cassidy.

At least 19 recordsLinked to original sources

Estimation of diffusion limitation after pneumonectomy from carbon monoxide diffusing capacity.

In three foxhounds, diffusing capacity for carbon monoxide (DLCO) was reduced by 25-30% after left pneumonectomy. Based on previous morphometric data in animals and physiologic data in humans, this reduction should not result in any impairment in gas exchange. However, experimental evidence indicates that diffusion limitation develops during exercise after pneumonectomy. Our objective is to determine whether this diffusion limitation to gas exchange can be predicted from physiologic measurements of DLCO. DLCO measured by the rebreathing technique was translated into diffusing capacity for O2 (DLO2) using an average conversion factor for canids obtained morphometrically (Weibel et al., Respir. Physiol. 54: 173-188, 1983). Arterial O2 saturation (SaO2) at various intensities of steady state exercise was calculated from DLO2 and measured values of O2 consumption, alveolar PO2, hemoglobin and arterial pH, and compared to observed SaO2. After pneumonectomy, SaO2 declined progressively with increasing exercise load. In all dogs, the observed pattern of arterial O2 saturation could be predicted from DLCO measured at similar work loads. The relationship between predicted (Pr) and observed (Ob) SaO2 is: SaO2(Pr) = 22.73 + 0.77SaO2(Ob), r = 0.92. The slope is significantly less than 1.0 (P less than 0.005), indicating that other factors must also contribute to arterial desaturation. We conclude that physiologic measurement of DLCO is a meaningful indicator of diffusion limitation to gas exchange. In the foxhound, a modest reduction in DLCO significantly impairs O2 transport during exercise; but other gas exchange abnormalities, e.g. ventilation perfusion inhomogeneity, must also develop.

Animals

Recruitment of lung diffusing capacity with exercise before and after pneumonectomy in dogs.

Although the left lung constitutes 42% of the total by weight and volume in dogs, carbon monoxide diffusing capacity (DL) after left pneumonectomy in adults falls less than 30% at rest, indicating a significant increase of DL in the remaining lung. DL normally increases during exercise, presumably by recruitment of alveolar capillaries and surface area as lung volume (Vs) and pulmonary blood flow (Qc) increase. We asked whether the increase of DL in the remaining lung after pneumonectomy in adult dogs could be explained by this kind of passive recruitment by the increased volume and Qc in the remaining lung. We measured the relationship between DL and Qc with a rebreathing technique at increasing treadmill loads in adult foxhounds, before and 6 mo after left pneumonectomy, and the relationship between DL and Vs by the same technique under anesthesia as Vs was expanded. DL was reduced by 29.1% at rest and 26.5% with heavy exercise after left pneumonectomy, indicating either recruitment or new growth in the right lung. With the assumption that the right lung normally receives 58% of the Qc and contains 58% of the DL, DL of the right lung increased with Qc in accordance with the following relationships before and after left pneumonectomy: right lung DL (before pneumonectomy) = 6.44 + 2.40(Qc) (r = 0.963) and right lung DL (after pneumonectomy) = 7.51 + 1.75(Qc) (r = 0.958). Only approximately 7% of the increase in DL from rest to peak exercise could be attributed to the increase in Vs during exercise before pneumonectomy and approximately 15% after pneumonectomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Effect of pneumonectomy on the remaining lung in dogs.

To determine the magnitude of functional compensation after pneumonectomy and whether compensation is related to maturity of the animal at the time of resection, we performed left pneumonectomy in either adult or 10-wk-old beagles. Studies were performed in adults 7-9 mo after surgery and in puppies 18-23 mo after surgery when the dogs reached full maturity. Results were compared with those in age- and sex-matched unoperated controls. Measurements included pressure-volume relationships, pulmonary hemodynamics, rebreathing studies of lung volume, diffusing capacity and its components, lung tissue volume, and pulmonary blood flow. Computerized-tomographic scans were performed in the puppy groups to determine changes in thoracic shape and size. Morphometric analysis of the lungs was performed under light microscopy. There was partial compensation for loss of one lung by functional improvement in the remaining lung. Compensation was greater in those pneumonectomized as puppies than as adults. Volume of the remaining lung was larger than predicted for a given transpulmonary pressure in both groups. Diffusing capacity, pulmonary capillary blood volume, and lung tissue volume were larger than expected for the normal right lung. After pneumonectomy, compliance of the rib cage was greater in puppies than in adults. Weight of the costal diaphragm was reduced in pneumonectomized puppies. Pulmonary hypertension at rest did not develop, and pulmonary vascular reactivity to hypoxia was unchanged after pneumonectomy in both groups. Significant correlations were obtained between physiological and morphometric measurements.

Age Factors

Gas exchange abnormalities after pneumonectomy in conditioned foxhounds.

Loss of a major portion of lung tissue has been associated with impaired exercise capacity, but the underlying mechanisms are not well defined. We studied the alterations in gas exchange during exercise before and after left pneumonectomy in three conditioned foxhounds. After pneumonectomy, minute ventilation and O2 consumption at comparable submaximal work loads were unchanged but arterial PCO2 at any work load was higher, implying that ventilatory response to CO2 was impaired. Arterial hypoxemia and an elevated alveolar-arterial O2 tension difference (AaDO2) developed during heavy exercise. Using the multiple inert gas elimination technique, we determined the distributions of ventilation-perfusion (VA/Q) ratios postpneumonectomy. Significant increase in VA/Q inequality developed during exercise while the foxhounds were breathing room air, accounting for an average of 42% of the total increase in AaDO2 while diffusion limitation accounted for 58%. While the animals were breathing hypoxic gas mixture, diffusion limitation accounted for an average of 88% of the total increase AaDO2. Cardiac output and O2 delivery were reduced at a given O2 consumption after pneumonectomy. After pneumonectomy, the animals reached O2 consumptions close to the maximum expected for normal dogs. Compensation for the impairment in O2 delivery post-pneumonectomy occurred mainly by an increase in hemoglobin concentration. Training probably played an important role in returning exercise capacity toward prepneumonectomy levels. We conclude that significant abnormalities in gas exchange develop during exercise after loss of 42% of lung tissue, but the animals demonstrate a remarkable ability to compensate for these changes.

Animals

Hemodynamic changes after pneumonectomy in the exercising foxhound.

Pulmonary arterial pressure is higher during exercise after pneumonectomy than before. Several factors may contribute to the elevation, e.g., loss of vascular bed, overinflation of the remaining lung, and active pulmonary vasoconstriction. We measured hemodynamic changes during graded exercise in conditioned foxhounds and compared pulmonary pressure-flow relationships before and after left pneumonectomy. Pulmonary arterial pressure-flow relationship in the remaining lung is not altered by pneumonectomy, suggesting that the increase in pulmonary vascular resistance post-pneumonectomy is largely the passive consequence of increased pulmonary blood flow to the remaining lung. The potential for chronic hyperinflation of the remaining lung to increase pulmonary resistance after pneumonectomy may have been counterbalanced by a concomitant reduction in lung elastic recoil. Unexpectedly, both mean systemic blood pressure and hematocrit were higher with respect to cardiac output after pneumonectomy. Cardiac output and stroke volume at any given work load were lower after pneumonectomy than before, and heart rate response was unaltered. This pattern of responses suggests that increases in left and right ventricular afterload may have contributed to the reduction in cardiac output.

Animals

Diaphragmatic vasodilation elicited by pulmonary C-fiber stimulation.

This study was performed to assess the effect of pulmonary C-fiber stimulation with capsaicin on vascular resistance in the diaphragm. Nine dogs were anesthetized with pentobarbital sodium and were instrumented with right and left ventricular catheters. The left phrenic artery was isolated and perfused from an extracorporeal reservoir. Right ventricular capsaicin injections (5-20 micrograms/kg) caused significant decreases in phrenic perfusion pressure (-16%), systemic arterial pressure (-32%), and heart rate (-19%). Injection of identical doses of capsaicin into the left ventricle led to no significant changes in phrenic arterial perfusion pressure or systemic arterial pressure but a 10% decrease in heart rate. Bilateral cervical vagotomy eliminated the response to both right and left ventricular injection of capsaicin, as did administration of the autonomic ganglion blocker hexamethonium bromide. The results indicate that pulmonary C-fiber stimulation reflexly vasodilates vessels in the diaphragm.

Animals

Left ventricular coordinate systems.

Three-dimensional kinematics of radiopaque markers in anterior, posterior, septal, and lateral regions of a major equatorial plane were evaluated in anesthetized dogs by biplane fluoroscopy. Stationary coordinate systems measured marker locations recorded during diastole and systole from a contractile origin at the center of contraction at end systole and from a geometric origin at the intersection with the equatorial plane of the ventricular long axis at end diastole. A time-indexed system measured marker locations at end diastole and at end systole, respectively, from the locations of the geometric origin at end diastole and end systole. Compared to the stationary system with the geometric origin, both the stationary system with the contractile origin and the time-indexed system reduced the variability of the radial components of the contractile displacements between ventricular regions. In contrast to the other two systems, the system with the contractile origin reduced circumferential components to values not significantly different from zero. These results indicate that 1) abnormally contracting regions of the ventricle may be located and their size measured by determining the region where the radial component differs from that in the rest of the equatorial plane and 2) rotation in a major equatorial plane of the ventricle is significant, but the influence of rotation can be minimized by referencing ventricular dimensions to a coordinate system with an origin at the center of contraction.

Animals

Rapid in vivo determinations of instantaneous right ventricular pressure and volume in dogs.

We have developed a method for measuring in vivo canine right ventricular (RV) volume at a frequency of 60 Hz. In six dogs (17-22 kg), under pentobarbital anesthesia, 18 radiopaque markers were surgically implanted in the RV myocardium to maximally represent the RV shell. The xyz-coordinates of the markers were obtained from biplane cineradiographic recordings. RV volume was calculated from the polyhedron created by the markers by decomposing the polyhedron into 24 tetrahedrons, each of whose volumes could be solved from the xyz-coordinates of markers. RV volume was obtained each 16.7 ms, permitting detailed representation if RV volume dynamics. RV end-diastolic volume, end-systolic volume, and ejection fraction averaged 41.3 +/- 10.9, 23.0 +/- 5.8, and 0.44 +/- 0.05 ml, respectively. By simultaneously measuring RV pressure, RV pressure-volume loops were constructed that demonstrated that RV ejection occurred without significant isovolumic contraction, although isovolumic relaxation occurred at end systole. RV systolic elastance was determined in two dogs by imposing four levels of RV afterload. Maximal systolic elastance averaged 4.14 mmHg/ml under control conditions and 9.20 mmHg/ml during dobutamine infusion.

Animals

Ventricular ejection fractions of linear transformation and ellipsoid models.

Eigenvolumes calculated from a linear transformation model were found previously to be linearly related to balloon volumes in excised hearts. The present study analyzed endocardial marker kinematics in intact, contracting left ventricles by biplane cinefluorography. Ejection fractions of the linear transformation model were compared by linear regression analysis with those of an ellipsoidal model, whose ejection fractions had been documented previously in closed and open-chest dog preparations. Data from 10 dogs indicated a correlation coefficient of 0.98 and a regression equation with close similarity to the line of identity. Ejection fractions calculated from the linear transformation model are concluded to be proportional to actual ejection fractions in intact, beating left ventricles.

Algorithms

Quantification of pulmonary vascular occlusion in dogs by use of the diffusing capacity.

The purpose of these experiments was to quantify stagnant intrapulmonary blood caused by a pulmonary arterial occlusion (PAO). The hypothesis was that the diffusing capacity of the lung for CO (DLCO) would be altered little by PAO when measured with the usual inspired concentrations (0.3%) of CO, since stagnant blood distal to the occlusion takes up CO for 20 s or more before significant CO backpressure would develop. However, higher levels of CO (i.e., greater than or equal to 3%) would equilibrate faster with capillary blood (within 5-10 s), and DLCO measured 10-20 s subsequent to the high CO exposure would reflect only the DLCO in the unoccluded regions. Thus the fractional reduction in DLCO measured with 3% CO, with respect to that measured with 0.3% CO, should be related to the fractional occlusion of the pulmonary artery in a predictable way. We occluded the right pulmonary artery (RPAO), the left pulmonary artery (LPAO), or the left lower lobar artery (LLPAO) and found that DLCO measured during rebreathing a 0.3% CO mixture was 80, 87, and 94%, respectively, of the preocclusion value, whereas the DLCO measured during rebreathing a 3.3% CO mixture was 59, 73, and 87% of the preocclusion value. A computer model was developed to predict the reduction in DLCO at different levels of CO exposure that would be caused by varying fractions of PAO. Our data indicated that RPAO corresponded to a 42% vascular occlusion, LPAO a 35% occlusion, and LLPAO a 20% occlusion. Measurement of DLCO using low and high concentrations of CO might be useful in assessing the fraction of vascular bed occluded and in following noninvasively the course of vascular occlusion in a variety of pulmonary diseases.

Animals

Cardiac output and O2 consumption during inspiratory threshold loaded breathing.

In this study, noninvasive measurements of cardiac output and O2 consumption were performed to estimate the blood flow to and efficiency of the respiratory muscles that are used in elevated inspiratory work loads. Five subjects were studied for 4.5 min at a respiratory rate of 18 breaths/min and a duty cycle of 0.5. Studies were performed at rest without added respiratory loads and at elevated inspiratory work loads with the use of an inspiratory valve that permitted flow only when a threshold pressure was maintained. Cardiac output and O2 consumption were calculated using a rebreathing technique. Respiratory muscle blood flow and O2 consumption were estimated as the difference between resting and loaded breathing. Work of breathing was calculated by integrating the product of mouth pressure and volume. Increases in cardiac output and O2 consumption in response of 4.5 min loaded breathing averaged 1.84 l/min and 108 ml/min, respectively. No increases were seen in response to 20-s loaded breathing. In a separate series of experiments on four subjects, though, cardiac output increased for the first 2 min then leveled off. These results indicate that the increase in cardiac output was a metabolic effect of the increased work load and was not caused primarily by the influence of the highly negative intrathoracic pressure on venous return. Efficiency of the respiratory muscles during inspiratory threshold loading averaged 5.9%, which was similar to measurements of efficiency of respiratory muscles using whole-body O2 consumption that have been reported previously in humans and in dogs.

Adult

Noninvasive diffusing capacity and cardiac output in exercising dogs.

We have developed a rebreathing procedure to determine diffusing capacity (DLCO) and pulmonary blood flow (Qc) in the awake, exercising dog. A low dead space, leak-free respiratory mask with an incorporated mouthpiece was utilized to achieve mixing between the rebreathing bag and the dog's lung. The rebreathing bag was initially filled with approximately 1.0 liter of gas containing 0.6% C2H2, 0.3% C18O, 9% He, and 35-40% O2. End-tidal gas concentrations were measured with a respiratory mass spectrometer. The disappearance of C2H2 and C18O was measured with respect to He to calculate Qc and DLCO. Values for DLCO in dogs, expressed per kilogram of body weight, were much larger than those reported in humans. However, at a given level of absolute O2 consumption, measurements of absolute DLCO in dogs were comparable to those reported in humans by both rebreathing and steady-state methods at rest and near-maximal exercise. These results suggest that DLCO is more closely matched to the metabolic capacity (i.e., maximal O2 consumption) than to body size between these two species.

Animals

Heart-lung interactions in health and disease.

Heart-lung interactions is a term applied to the complex interplay between the functions of the heart and respiratory systems. This interdependence of respiratory and cardiac function takes place at several levels. First is a functional linkage between the respiratory and cardiovascular systems in the transport of oxygen and carbon dioxide. Second are reflex and humoral interconnections between the two systems. Third are mechanical interactions between the heart and lungs, which are elastic structures sealed within an expandable thorax. In recent years, most attention has been focused on these mechanical interactions, but it is appropriate to consider also the other ways the heart and lungs interact.

Animals

Pulmonary edema in dogs fails to cause reflex responses.

Pulmonary edema has been proposed as a stimulus for pulmonary C-fibers. Stimulation of pulmonary C-fibers causes depression of cardiovascular function and either tachypnea or apnea. Our objective was to determine whether pulmonary edema, induced by either increasing pulmonary vascular permeability with alloxan or hydrostatic challenges, would elicit depression of cardiovascular function or changes in frequency of inspiratory activity. Utilizing a preparation in which the left pulmonary vessels and left airway were isolated, we monitored systemic blood pressure (BP), heart rate (HR), and diaphragm contractions (DC) in 13 anesthetized dogs. Injection of alloxan into the left pulmonary artery (LPA) produced transient decreases in HR, BP, and frequency of DC within 20 s of injection with no subsequent cardiorespiratory changes up to 5 min. These alloxan injections also caused coagulation necrosis. Generation of hydrostatic pulmonary edema in the left lung caused no changes in HR, BP, or in the frequency and amplitude of DC. We conclude that alloxan does stimulate reflex cardiorespiratory depression consistent with C-fiber stimulation, but these reflex responses are probably caused by alloxan's caustic effect and not by the resultant edema. We also conclude that pulmonary edema induced by increased hydrostatic pressure does not evoke any reflex cardiovascular responses or changes in frequency of inspiratory activity.

Alloxan

Reflex cardiorespiratory responses to pulmonary vascular congestion.

The purpose of these studies was to determine the reflex responses of the cardiovascular system and central inspiratory activity caused by pulmonary vascular congestion. We used a canine preparation in which the left lung was isolated in situ and could be exposed to a variety of stimuli, including distension of the pulmonary capillaries with blood, without direct mechanical or chemical alterations on the circulation. We found that lung expansion to 30 cmH2O and stimulation of nerve endings of the left lung with capsaicin caused pronounced transient reflex bradycardia (-30 to -50 beats/min) and hypotension (-25 to -40 mmHg) and caused reflex cessation of inspiratory activity. Pressurizing the left pulmonary vessels by injecting blood in volumes sufficient to raise pulmonary transcapillary pressures to 30 mmHg caused no changes in heart rate, systemic arterial pressure, or inspiratory muscle activity. These results lead us to conclude that pulmonary vascular congestion does not stimulate pulmonary C-fibers or any other nerve endings to such a degree as to cause detectable changes in blood pressure, heart rate, or central inspiratory activity. Morphometric analysis revealed distended capillaries engorged with blood, but the alveolar wall surface area was not increased which raises the possibility that expansion of the alveolar membrane may be needed to mechanically initiate the C-fiber reflex.

Animals

Inhibition of skeletal muscle activity by lung expansion in the dog.

The ability of lung expansion to reflexly decrease skeletal muscle activity was tested in anesthetized dogs. In animals whose left lung was vascularly isolated but neurally intact, the left lung was inflated statically to 40 cmH2O pressure or cyclically with tidal volumes of 10, 20, or 30 ml/kg. Responses to these stimuli were compared with those of injecting 120 or 240 micrograms capsaicin into the left pulmonary artery. Skeletal muscle activity was assessed from the electromyogram (EMG) response of the left hindlimb muscles and from the monosynaptic reflex response to a periodic patellar tendon tap of the right leg (knee jerk). Static inflation and cyclic inflations above 10 ml/kg resulted in significant decreases in both EMG and knee jerk responses. The results indicate that lung expansion is capable of initiating a reflex decrease in skeletal muscle activity. Capsaicin injections caused responses that were similar to those caused by lung inflation, suggesting that at least part of this skeletal muscle reflex response to lung inflation can be attributed to the stimulation of pulmonary C-fibers that could be caused by stretch of the lung.

Animals

Changes in left ventricular geometry during spontaneous breathing.

The purpose of these experiments was to determine the effects of a spontaneously generated inspiration on the size and shape of the left ventricle (LV) in anesthetized supine dogs. We implanted markers in the LV to establish three perpendicular axes and recorded the motion of these markers using biplane cinefluoroscopy at 60 Hz. The primary changes in LV size that accompanied inspiration occurred at end diastole (ED). The largest change in LVED dimension was a 2.46-mm narrowing of the septal-lateral wall dimension, but the apex-base dimension decreased also, by 0.74 mm. The anteroposterior dimension actually widened by 1.07 mm. The septal-lateral narrowing was caused by both a 1.0-mm narrowing of the distance between the septal marker and the apex-base axis, as well as by a 1.4-mm narrowing between the apex-base axis and the lateral wall marker. Narrowing of the septal portion seemed expected because of presumed enhanced right ventricular filling during inspiration. Narrowing of the lateral portion of the LV, while the anteroposterior dimension widened, was surprising because a change in LVEDV shape is implied. Assuming ventricular homogeneity, this change in LVED shape implies that the forces applied to the epicardial surface were not uniform. There must have been a retraction on the anterior and posterior surface that was not experienced by the lateral LV wall. The net effect of these dimensional changes of the LV at end diastole (estimated from the product of the three ED axes) was a 3.5-cm3 reduction in LVED volume.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals