Effect of cardiogenic gas mixing on arterial O2 and CO2 tensions during breath holding.

To examine the effect of cardiogenic gas mixing on gas exchange we measured arterial tension of O2 (PaO2) and arterial tension of CO2 (PaCO2) during 3- to 5-min breath holds (BH) before and after infusing 50 ml of saline into the pericardial space (PCF) of seven anesthetized, paralyzed, mechanically ventilated dogs. During BH the ventilator was disconnected and a bias flow of 50% O2 at 4-5 l/min was delivered through the side ports of a small catheter whose tip was positioned 1 cm cephalad of the carina. Paired runs, alternately with and without PCF, were performed in triplicate in each dog. Initial PaO2 was similar for control runs [81 +/- 3 mmHg (SE)] and PCF runs (78 +/- 3 mmHg; P greater than 0.1). After 3-min BH, PaO2 in PCF runs (33 +/- 3 mmHg) was less than that in control runs (58 +/- 4 mmHg) (P less than 0.001). In contrast, the pattern of PaCO2 during BH did not differ with PCF. After 3-min BH, PaCO2 was 49 +/- 3 mmHg with PCF and 49 +/- 2 mmHg in the control runs (P greater than 0.7). In two dogs, repeated 50-ml reductions in lung volume, produced by rib cage compression, did not alter the time course of PaO2 during BH. Although cardiac output decreased slightly with PCF, hemodynamic changes due to PCF were unlikely to account for the observed fall in PaO2. Our results indicate a substantial effect of cardiogenic gas mixing on O2 uptake when tracheal gas is O2 enriched during breath holding.(ABSTRACT TRUNCATED AT 250 WORDS)

Upper airway dimensions and movements in bronchial asthma.

We measured the diameter and vertical displacement of the laryngeal and oropharyngeal airways in 8 seated asymptomatic asthmatic subjects (31 to 60 yr of age) before and after bronchoconstriction (BC) induced by histamine phosphate aerosol. An image of the airways was obtained in 2 planes using an X-ray fluoroscope attached to a videotape recorder, onto which signals of flow and volume at the mouth were recorded simultaneously. We calculated real dimensions from the video image using size markers included in the picture. During BC, when FEV1 fell to 35 +/- 4% (mean +/- SE) of control, the lateral diameter (DLAT) of the larynx at mid-expiration narrowed over approximately 10 mm vertical height above the glottis. Lateral diameter of the glottis during mid-expiration fell from 6.5 +/- 1.5 mm by 46 +/- 12% (p less than 0.05), but that during inspiration was unchanged. In the 3 subjects with the greatest glottic narrowing, anteroposterior diameter (DAP) and DLAT of the larynx at the level of the corniculate cartilages narrowed by 28 and 27%, respectively. There was inspiratory dilatation of the oropharynx during BC. The DAP during inspiration at the level of the hyoid increased from 15.0 +/- 1.5 to 17.5 +/- 1.5 mm (p less than 0.05), while that at the level of the third cervical vertebra (C3) increased from 12.5 +/- 1.5 to 17.0 +/- 2.0 mm (p less than 0.05). The diameters during mid-expiration were unchanged so that the difference between inspiration and mid-expiration increased at both levels. Higher in the oropharynx (20 mm above C3), expiratory DAP decreased in 6 of 8 subjects.(ABSTRACT TRUNCATED AT 250 WORDS)