Relationship between CO and transit times for dye and thermal indicators in central circulation.

We investigated two factors that may influence the estimation of lung water by the thermal-dye double-indicator-dilution method: 1) changes in cardiac output (CO), and 2) thermal equilibration with cardiac tissue. In theory, the difference between mean transit times of thermal and dye indicators (delta MTT) is proportional to the extravascular volume of distribution of the thermal indicator (VODev) and inversely related to CO. The delta MTT also includes a time element DT due to the difference in response times of the measuring instruments such that delta MTT = VODev/CO + DT. In nine anesthetized dogs we recorded 286 aortic thermal and dye curves following left atrial (LA) and right atrial (RA) injections as CO was increased from 2.35 to 6.65 ml X s-1 X kg-1 by isoproterenol infusion, and a regression of delta MTT on CO-1 was performed. DT was measured in vitro for comparison with the y-intercept. In six of nine dogs the slope of the regression for LA injections was not different from zero, indicating that there is no measurable volume of distribution for thermal indicator in cardiac tissue. For RA injections the relationship between delta MTT and CO-1 was linear in all experiments, with an average correlation coefficient of 0.97 +/- 0.01 (SE), indicating that the VODev was constant over a threefold increase in CO. Although the in vitro measurement of DT agreed closely with the average of the y-intercepts of the regressions, small between-subject differences in DT can lead to apparent flow-related changes in extravascular thermal volume computed in the conventional fashion using the in vitro estimate of DT.

Effect of edema and hemodynamic changes on extravascular thermal volume of the lung.

The extravascular thermal volume of the lung (ETV) has been measured in dogs as the difference between mean transit time (t) volumes for heat and indocyanine green dye across the pulmonary circulation, calculated as the product of thermal dilution cardiac output (CO) and the difference in t for aortic indicator-dilution curves generated by right and left atrial injections. ETV measurements were compared with the extravascular lung mass (ELM): in 21 normal dogs, ETV/ELM = 1.11 +/- 0.14 (SD); in 17 dogs with hydrostatic pulmonary edema (up to 21 g/kg), ETV/ELM = 0.90 +/- 0.11; and in 27 dogs with alloxan pulmonary edema (up to 51 g/kg); ETV/ELM = 0.93 +/- 0.13. For all 65 dogs the mean ETVELM was 0.98 +/- 0.15, and the liner regression was ETV (ml/kg) = 0.90 ELM (g/kg) + 0.86 +/- 2.25 (SEE; r = 0.96). Calculations based on measurements of lung specific heat predict that ETV/ELM should equal 0.984. With acute changes in pulmonary hemodynamics, ETV was reduced by reductions in pulmonary arterial pressure (Ppa) sufficient to produce zone 1 conditions at the top of the lung. However, ETV was not affected by increases in CO (mean = 50%) produced by nitroprusside or by increases in Ppa and pulmonary blood volume (mean = 27%) produced by partial mitral valve obstruction. Distortion of the thermal dilution curve due to position of the arterial thermistor appears to be the greatest source of variability and overestimation. Simultaneous measurements from pairs of thermistors differed by 14% (range 0.4-50%).

Effect of atelectasis and embolization on extravascular thermal volume of the lung.

The extravascular volume of distribution for heat in the lung has been advocated for the measurement of lung water. The purpose of these experiments was to investigate how extremes of ventilation-perfusion mismatch influence this measurement. Twenty-six dogs were studied with right and left atrium-to-aorta thermal and dye-dilution curves before and 60 min after total right main-stem bronchial obstruction or microembolization of the pulmonary circulation with 0.275-mm glass beads. Whereas atelectasis had no influence on our measurements, embolization with 0.32 g/kg of beads decreased the detected pulmonary blood volume from 10.63 to 8.55 ml/kg and increased the extravascular thermal volume (ETV) from 9.89 to 10.99 ml/kg. Embolization with 0.65 g/kg decreased the detected ETV from 9.29 to 8.38 ml/kg, while the extravascular wet-to-dry weight ratio was increased, and the regression of postmortem extravascular mass on ETV differed from control. We conclude that microembolization but not atelectasis causes errors in the measurement of lung fluid when the thermodye technique is used. The errors are variable and depend on the degree of embolization.

Empiric analysis of the interactions involved in the formation of Fc receptor rosettes.

Erythrocytes coated with IgG were used in forming rosettes with lymphocytes and polymorphonuclear leukocytes to investigate Fc receptors. The density of the IgG-Fc coating on erythrocytes predictable influenced the number of rosettes formed with leukocytes. This relationship could be empirically described by application of the Hill equation derived from studies of molecular interactions in other biologic systems. The approximate Hill coefficient for Fc receptors was 2.4. These findings suggest at least two possible models for membrane Fc receptor function.