PubMed · 8965865
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V M Weinstock, S J Weinstock. 1996-11-28. Hyperbaric-oxygen therapy.. https://pubmed.ncbi.nlm.nih.gov/8965865/
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It is well known that scorpion venom induces lung lesions and respiratory distress which are usually classified as pulmonary oedema (PO). Tityus discrepans is a scorpion that lives in the north-central area of Venezuela, is the most common source of human envenomation here and produces PO. We studied the action of the venom of Tityus discrepans on whole rabbits and on their isolated lungs perfused with Krebs saline with 1 g/l of bovine serum albumin (Krebs-BSA saline). Two milligram of venom were diluted in 250 ml of solution (approximately the rabbit's total blood volume) and used to perfuse isolated lungs. Lung oedema occurred in rabbits which received 1 mg/kg of scorpion venom i.p., heparin prevented the production of this lung oedema. T. discrepans venom produced PO, in rabbits pretreated with 15 mg/kg of ajoene. Yet, Tityus venom had no effects on isolated lungs perfused with citrated or heparinized blood, and in lungs perfused with Krebs-BSA with normal Ca2+. These result show that Tityus venom does not act directly on lungs. Otherwise, we have observed that abundant microthrombi occurred in all rabbit lungs exposed to venom in vivo, suggesting that these clotting alterations are fundamental to produce PO. The presence of intravascular microthrombi is not characteristic of the usual PO hinting that scorpion venom induced pulmonary alterations are a different clinical entity. We thus propose that the use of the term pulmonary oedema in scorpionism should abandoned in favor of scorpion venom respiratory distress syndrome.
Dynamic collapse of the pulmonary airways, leading to flow limitation, is a significant event in a number of respiratory pathologies, including obstructive sleep apnea syndrome and chronic obstructive pulmonary disease. Quantitative evaluation of the mechanical status of the respiratory system in these conditions provides useful insights into airway caliber and tissue stiffness, which are hallmarks of such abnormalities. However, assessing respiratory mechanics in the presence of flow limitation is problematic because the single-compartment linear model on which most assessment methods are based is not valid over the entire breath. Indeed, even deciding which parts of a breath are flow limited from measurement of mouth flow and pleural pressure often proves to be difficult. In this study, we investigated the use of two approaches to assessing the overall mechanical properties of the respiratory system in the presence of inspiratory flow limitation. The first method is an adaptation of the classic Mead-Whittenberger method, and the second method is based on information-weighted histograms obtained from recursively estimated signals of respiratory resistance and elastance. We tested the methods on data simulated by using a computer model of the respiratory system and on data collected from obese sleeping pigs. We found that the information-weighted histograms provided the more robust overall estimates of respiratory mechanics.
Interdependence between airways and the lung parenchyma is thought to be a major mechanism preventing excessive airway narrowing during bronchoconstriction. Because the elastance of the lung increases during bronchoconstriction, the lung's tethering force could also increase, further attenuating bronchoconstriction. We hypothesized that the bulk (kappa) and shear moduli (mu) of the lung increase similarly during bronchoconstriction. To test this hypothesis, we excised rabbit lungs and measured the lung volume, pulmonary elastance, kappa, and mu at transpulmonary pressures of 4, 6, 8, 12, and 16 cmH2O using pressure-volume curves, slow oscillations of the lung, and an indentation test. Bronchoconstriction was induced by nebulizing carbachol by using small tidal-volume ventilation to prevent hyperinflation. The measurement of kappa and mu was repeated after carbachol treatment. After carbachol treatment, the increase in kappa was significantly greater than that in mu. The estimated value for mu was approximately 0.5 x transpulmonary pressure both before and after carbachol treatment. These data suggest that the tethering effect of the lung parenchyma, which serves to attenuate bronchoconstriction, is not significantly increased during carbachol administration unless there is hyperinflation.