Determination of Central Blood Volume and Extravascular Lung Water

1987 ◽  
Vol 35 (01) ◽  
pp. 53-56 ◽  
Author(s):  
J. Böck ◽  
A. Hoeft ◽  
H. Korb ◽  
R. de Vivie ◽  
G. Hellige
1992 ◽  
Vol 72 (5) ◽  
pp. 1868-1886 ◽  
Author(s):  
J. Dupuis ◽  
C. A. Goresky ◽  
J. W. Ryan ◽  
J. L. Rouleau ◽  
G. G. Bach

We examined exercise-induced changes in indicator-dilution estimates of the angiotensin-converting enzyme first-order kinetic parameter, the ratio of a normalized maximal enzymatic conversion rate to the Michaelis constant (Amax/Km), which, under stable enzymatic conditions, will vary with the pulmonary vascular surface area accessible to vascular substrate, the extravascular lung water (an index of the proportion of lung tissue perfused), and the central blood volume (from pulmonary trunk to aorta). Experiments were performed in 10 mongrel dogs at rest and through two increasing levels of treadmill exercise, with the use of two vascular space tracers (labeled erythrocytes and albumin), a water space tracer ([1,8–14C]-octanediol), and a vascular endothelium surface area marker, benzoyl-Phe-Gly-Pro ([3H]BPGP), which is a pharmacologically inactive angiotensin-converting enzyme substrate. The exercise-induced increase in cardiac output was accompanied by a linear increase in central blood volume, and dilutional extravascular lung water rapidly increased to an asymptotic proportion close to 100% of postmortem vascular lung water. There was an average 55% [3H]BPGP hydrolysis, which did not vary with flow, and the computed Amax/Km increased linearly with exercise. We conclude that exercise results in complete lung tissue recruitment and increases the pulmonary vascular surface area available for BPGP hydrolysis linearly with flow, so that pulmonary vascular recruitment continues after full tissue recruitment.


1986 ◽  
Vol 30 (4) ◽  
pp. 309-313 ◽  
Author(s):  
C. Frostell ◽  
H. Blomqvist ◽  
G. Hedenstierna ◽  
R. Pieper ◽  
I. Halbig

1996 ◽  
Vol 80 (1) ◽  
pp. 30-46 ◽  
Author(s):  
J. Dupuis ◽  
C. A. Goresky ◽  
J. L. Rouleau ◽  
G. G. Bach ◽  
A. Simard ◽  
...  

The multiple indicator-dilution technique was employed in the exercising dog to evaluate the effect of increasing activity on the pulmonary extraction and kinetics of removal of tracer 3H-labeled serotonin (5-HT) and on the measured central blood volume and tracer-accessible extravascular lung water. 51Cr-labeled red blood cells, 125I-labeled albumin, and 14C-labeled 1,8-octanediol were injected with labeled 5-HT at rest and at two increasing levels of exercise (lower and higher in 9 dogs). Blood flow approximately tripled at the highest level of exercise, and the central blood volume increased linearly with increasing blood flow. The tracer-accessible extravascular lung water increased in the transition from rest to low-level exercise and stabilized at an average proportion of 0.85 of the gravimetric extravascular lung water at the higher values of blood flow. The average labeled 5-HT extraction at rest was 42 +/- 11%, and this slowly decreased with increase in flow. The calculated permeability-surface area product for 5-HT increased approximately directly with increasing blood flow. We conclude that exercise results in an increase in the central blood volume that is accompanied by an increase in the tracer-accessible extravascular lung water (lung tissue recruitment) over low exercise levels, with no change at higher levels of exercise, and that the pulmonary capillary surface area subserving 5-HT uptake increases almost linearly with flow over the range of flows attained.


1994 ◽  
Vol 76 (5) ◽  
pp. 1868-1875 ◽  
Author(s):  
C. J. Wallin ◽  
L. G. Leksell

In the present human study we evaluated a newly developed double-indicator-dilution densitometric system for the estimation of cardiac output (Q), central blood volume (CBV), and extravascular lung water (EVLW) by using indocyanine green and heavy water (2H2O) as indicators. Eighteen cardiopulmonary healthy patients scheduled for abdominal surgery were studied. A routine anesthesia procedure was used [thiopental (3–5 mg/kg), N2O (inspired fraction of O2 = 0.4), and isoflurane (end tidal 0.5–1.5%)]. Q, CBV, and EVLW were measured at seven defined data collection points: awake, anesthetized spontaneously breathing, apneic, mechanically ventilated with and without positive end-expiratory pressure, post-operatively anesthetized, and postoperatively awake. During the whole study EVLW (3.8 +/- 0.9 ml/kg) was stable in the presence of large fluctuations in Q (2.5–10.1 l/min) and CBV (0.8–2.4 l). We concluded that the method is versatile and of low invasiveness, allowing reliable on-line Q and EVLW data for repeated measurements in the clinical setting.


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