Document Detail

Separating in vivo mechanical stimuli for postpneumonectomy compensation: physiological assessment.
MedLine Citation:
PMID:  23104695     Owner:  NLM     Status:  MEDLINE    
Following right pneumonectomy (PNX), the remaining lung expands and its perfusion doubles. Tissue and microvascular mechanical stresses are putative stimuli for initiating compensatory lung growth and remodeling, but their relative contributions to overall compensation remain uncertain. To temporally isolate the stimuli related to post-PNX lung expansion (parenchyma deformation) from those related to the sustained increase in perfusion (microvascular distention and shear), we replaced the right lung of adult dogs with a custom-shaped inflated prosthesis. Following stabilization of perfusion and wound healing 4 mo later, the prosthesis was either acutely deflated (DEF group) or kept inflated (INF group). Physiological studies were performed pre-PNX, 4 mo post-PNX (inflated prosthesis, INF1), and again 4 mo postdeflation (DEF) compared with controls with simultaneous INF prosthesis (INF2). Perfusion to the remaining lung increased ~76-113% post-PNX (INF1 and INF2) and did not change postdeflation. Post-PNX (INF prosthesis) end-expiratory lung volume (EELV) and lung and membrane diffusing capacities (DL(CO) and DM(CO)) at a given perfusion were 25-40% below pre-PNX baseline. In the INF group EELV, DL(CO) and DM(CO) remained stable or declined slightly with time. In contrast, all of these parameters increased significantly after deflation and were 157%, 26%, and 47%, respectively, above the corresponding control values (INF2). Following delayed deflation, lung expansion accounted for 44%-48% of total post-PNX compensatory increase in exercise DL(CO) and peak O(2) uptake; the remainder fraction is likely attributable to the increase in perfusion. Results suggest that expansion-related parenchyma mechanical stress and perfusion-related microvascular stress contribute in equal proportions to post-PNX alveolar growth and remodeling.
D Merrill Dane; Cuneyt Yilmaz; Aaron S Estrera; Connie C W Hsia
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-10-25
Journal Detail:
Title:  Journal of applied physiology (Bethesda, Md. : 1985)     Volume:  114     ISSN:  1522-1601     ISO Abbreviation:  J. Appl. Physiol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-02     Completed Date:  2013-07-08     Revised Date:  2014-01-09    
Medline Journal Info:
Nlm Unique ID:  8502536     Medline TA:  J Appl Physiol (1985)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  99-106     Citation Subset:  IM    
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MeSH Terms
Airway Remodeling / physiology*
Lung / blood supply,  physiology*,  surgery
Lung Volume Measurements / methods
Microvessels / physiology*
Perfusion / methods
Physical Conditioning, Animal / physiology
Pneumonectomy / methods
Prostheses and Implants
Pulmonary Gas Exchange / physiology
Regional Blood Flow / physiology
Respiratory Function Tests / methods
Stress, Mechanical
Wound Healing / physiology*
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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