Analysis of the effect of inert gas on alveolar/venous blood partial pressure by using the operator splitting method.

This study aims to investigate how inert gas affects the partial pressure of alveolar and venous blood using a fast and accurate operator splitting method (OSM). Unlike previous complex methods, such as the finite element method (FEM), OSM effectively separates governing equations into smaller sub-problems, facilitating a better understanding of inert gas transport and exchange between blood capillaries and surrounding tissue. The governing equations were discretized with a fully implicit finite difference method (FDM), which enables the use of larger time steps. The model employed partial differential equations, considering convection-diffusion in blood and only diffusion in tissue. The study explores the impact of initial arterial pressure, breathing frequency, blood flow velocity, solubility, and diffusivity on the partial pressure of inert gas in blood and tissue. Additionally, the effects of anesthetic inert gas and oxygen on venous blood partial pressure were analyzed. Simulation results demonstrate that the high solubility and diffusivity of anesthetic inert gas lead to its prolonged presence in blood and tissue, resulting in lower partial pressure in venous blood. These findings enhance our understanding of inert gas interaction with alveolar/venous blood, with potential implications for medical diagnostics and therapies.

Twins with alveolar capillary dysplasia with misalignment of pulmonary veins: Strategies for diagnosis and management.

We present a case of dichorionic-diamniotic twin females who developed hypoxemic respiratory failure. They were ultimately diagnosed by lung biopsy with alveolar capillary dysplasia with misalignment of pulmonary veins. This case highlights a practical approach to reaching a diagnosis in infants with suspected developmental lung disease.

The architecture of alveolar capillaries in the lungs of bactrian camels (Camelus bactrianus) / Arquitectura de los capilares alveolares de pulmones de camellos bactrianos (Camelus bactrianus)

SUMMARY: The Bactrian camel, which is native to China and Mongolia, is large in size and is an even-toed ungulate species. The double humps on the Bactrian camel back differentiate it from the dromedary camel, which has a single hump. This species has adapted to unsuitable conditions (lack of food and water) in the Gobi Desert and is advanced in unique anatomical and physiological characteristics during a prolonged evolution period. Several studies have been conducted on the anatomical features of the Bactrian camel, but none have given attention to the alveolar capillaries of the Bactrian camel lung. Therefore, the current study aims to explore the architecture of the alveolar capillary in the Bactrian camel lung and further explain the mechanism of blood flow in its lung. The current study extracted and examined the architecture of the alveolar capillary in the lung of the Bactrian camel (Camelus bactrianus) and further explained the mechanism of blood flow by performing lung casting and replica scanning electron microscopy methods. The reports showed that the resources of the alveolar-capillary originated from the capillaries of the subpleural space or interlobular septulum, sometimes originating from the precapillary arterioles or directly from the terminal arterioles. The alveolar capillaries anastomosed and formed a single layer of dense, basket-like network surrounding the alveolus. The mash diameter of the alveolar-capillary network was larger than that of the capillary, and the appearance of the mash was oval and elliptical. Many of the collapsed alveolar-capillary networks were found in the alveolar microvascular architecture in the lung of the Bactrian camel. The study found that, due to many collapsed alveoli in the Bactrian camel lung, the disproportional pressure between the pulmonary alveoli induced less imbalance of blood flow in the alveolar capillary, which affected the gas exchange efficiency. Therefore, the function of the anastomosing capillary branch was likely to regulate the blood flow between the alveolar-capillary network.

RESUMEN: El camello bactriano, es originario de China y Mongolia, es de gran tamaño y es una especie de ungulado de dedos pares. Las dobles jorobas del lomo del camello bactriano lo diferencian del dromedario, que tiene una sola joroba. Esta especie se ha adaptado a condiciones inadecuadas (falta de alimento y agua) en el desierto de Gobi y ha avanzado en características anatómicas y fisiológicas únicas durante un período de evolución prolongado. Se han realizado varios estudios sobre las características anatómicas del camello bactriano, pero ninguno ha prestado atención a los capilares alveolares del pulmón de este animal. Por lo tanto, el presente estudio tuvo como objetivo principal explorar la arquitectura del capilar alveolar en el pulmón del camello bactriano y explicar el mecanismo del flujo sanguíneo. A partir de nuestro trabajo se examinó la arquitectura del capilar alveolar en el pulmón del camello bactriano (Camelus bactrianus) mediante la realización de métodos de microscopía electrónica de barrido y escaneo pulmonar. Los informes mostraron que los recursos del alvéolo-capilar se originaban en los capilares del espacio subpleural o del tabique interlobulillar y a veces se originaban en las arteriolas precapilares o directamente en las arteriolas terminales. Los capilares alveolares se anastomosaban y formaban una densa red de capa única en forma de cesta que rodeaba el alvéolo. El diámetro del macerado de la red alveolar-capilar era mayor que el del capilar y el aspecto del macerado era ovalado y elíptico. Muchas de las redes alvéolo-capilares colapsadas se encontraron en la arquitectura microvascular alveolar en el pulmón del camello bactriano. El estudio encontró que, muchos alvéolos colapsados en el pulmón del camello bactriano, la presión desproporcionada entre los alvéolos pulmonares inducía un menor desequilibrio del flujo sanguíneo en el capilar alveolar, lo que afectaba la eficiencia del intercambio de gases. Por lo tanto, la función de la rama capilar anastomosante probablemente regularía el flujo sanguíneo entre la red alveolar-capilar.

The effects of positive end-expiratory pressure in alveolar recruitment during mechanical ventilation in pigs / Os efeitos da pressão positiva expiratória final no recrutamento alveolar durante a ventilação mecânica em porcos

PURPOSE: To evaluate the effects of alveolar recruitment based on mean airway pressure (MAP) on pig lungs submitted to thoracotomy through blood gas exchange and hemodynamic parameters. METHODS: Twelve pigs weighting approximately 25Kg were intubated and ventilated on volume controlled ventilation (tidal volume 10ml/Kg, respiratory rate 16min, FiO2 1.0, inspiratory:expiratory ratio 1:2, PEEP 5cmH2O). The animals were then randomized into two groups: control and left lateral thoracotomy. The PEEP was increased at each 15-minute intervals to reach a MAP of 15, 20 and 25cmH2O, respectively. Hemodynamic, gas exchange and respiratory mechanic data were measured immediately before each PEEP change. RESULTS: There were no significant differences between both groups in all parameters analyzed (P=1.0). The PaO2, PaCO2, MAP, PAP and plateau pressure were significantly worse at MAP of 25cmH2O, when compared with the other values of MAP (P=0.001, P=0.039, P=0.001, P=0.016 e P=0.027, respectively). The best pulmonary performance according to the analyzed parameters was observed at MAP of 20cmH2O. CONCLUSION: PEEP adjusted to MAP of 20cmH2O resulted in best arterial oxygenation, without compromising the venous return, as opposed to MAP of 25cmH2O, which caused deterioration of gas exchange, hemodynamics and respiratory mechanic.

OBJETIVO: Avaliar os efeitos do recrutamento alveolar baseado na pressão média das vias aéreas (Pmédia) sobre os pulmões de porcos submetidos a toracotomia, através de dados gasométricos e hemodinâmicos. MÉTODOS: Doze porcos machos pesando em média 25Kg receberam indução anestésica, sendo intubados e ventilados a volume (FiO2=1.0, volume corrente=10 ml/kg/min, FR=16 cpm, relação I:E=1:2 e PEEP 5 mmHg). Os animais foram randomizados em dois grupos: controle e toracotomia lateral esquerda. Os valores de PEEP em cada grupo foram aumentados a cada 15 minutos para atingir valores de Pmédia de 15, 20 e 25cmH2O, sendo coletados dados hemodinâmicos, gasometria arterial e mecânica respiratória imediatamente antes de cada acréscimo do PEEP. RESULTADOS: Não houve diferença estatisticamente significativa entre os 2 grupos em todos os parâmetros analisados (P=1,0). Ocorreu piora significativa da PaO2, PaCO2, pressão arterial média, pressão da artéria pulmonar e pressão de platô com Pmédia de 25cmH2O comparado com os demais valores de Pmédia (P=0.001, P=0.039, P=0.001, P=0.016 e P=0.027, respectivamente). O melhor desempenho pulmonar pelos parâmetros analisados ocorreu com a Pmédia de 20cmH2O. CONCLUSÃO: As manobras de recrutamento alveolar alteram o desempenho pulmonar e função hemodinâmica independemente da cavidade torácica estar aberta ou fechada. O PEEP ideal para o recrutamento alveolar independente dos grupos estudados foi obtido a uma Pmédia de 20cmH2O em relação a todos os parâmetros analisados.

Two alternative models concerning the perialveolar microcirculation in mammalian lungs

Despite the fact that the concept of sheet-flow in the pulmonary microcirculation of mammals was introduced more than three decades ago, the capillary circulatory model still prevails in the physiological literature. Since cardiac output is identical in the systemic and in pulmonary circulations, it is noteworthy that in the former, the resulting arterial pressure is five times higher than that of the latter, which means that the corresponding microcirculations must be radically different. The present study addresses this problem from both morphological and physiological perspectives.