Hyperinflation with intrinsic PEEP and respiratory muscle blood flow

Y. Kawagoe, S. Permutt, Henry Eric Fessler

Research output: Contribution to journalArticle

Abstract

Increased end-expiratory lung volume and intrinsic positive end- expiratory pressure (PEEP) are common in obstructive lung disease, especially during exacerbations or exercise. This loads the respiratory muscles and may also stress the circulatory system, causing a reduction or redistribution of cardiac output. We measured the blood flow to respiratory muscles and systemic organs using colored microspheres in 10 spontaneously breathing anesthetized tracheotomized dogs. Flows during baseline breathing (BL) were compared with those during hyperinflation (HI) induced by a mechanical analogue of airway closure and with those during an inspiratory resistive load (IR) that produced an equivalent increase in inspiratory work and time- integrated transdiaphragmatic pressure. Cardiac output was unchanged during IR (3.19 ± 0.27 l/min at BL, 3.09 ± 0.34 l/min during IR) but was reduced during HI (2.14 ± 0.29 l/min; P <0.01). Among the organs studied, flow was unaltered by IR but decreased to the liver and pancreas and increased to the brain during HI. For the respiratory muscles, flow to the diaphragm increased during IR. However, despite a 1.9-fold increase in inspiratory work per minute and a 2.5-fold increase in integrated transdiaphragmatic pressure during HI, blood flow to the diaphragm was unchanged and flow to the scalenes and sternomastoid fell. The only respiratory muscle to which flow increased during HI was the transversus abdominis, an expiratory muscle. We conclude that the circulatory effects of hyperinflation in this model impair inspiratory muscle perfusion and speculate that this may contribute to respiratory muscle dysfunction in hyperinflated states.

Original languageEnglish (US)
Pages (from-to)2440-2448
Number of pages9
JournalJournal of Applied Physiology
Volume77
Issue number5
StatePublished - 1994

Fingerprint

Respiratory Muscles
Positive-Pressure Respiration
Respiration
Diaphragm
Cardiac Output
Obstructive Lung Diseases
Pressure
Abdominal Muscles
Muscles
Cardiovascular System
Microspheres
Pancreas
Perfusion
Dogs
Lung
Liver
Brain

Keywords

  • cardiac output
  • cardiopulmonary interactions
  • microspheres
  • respiratory failure

ASJC Scopus subject areas

  • Endocrinology
  • Physiology
  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Hyperinflation with intrinsic PEEP and respiratory muscle blood flow. / Kawagoe, Y.; Permutt, S.; Fessler, Henry Eric.

In: Journal of Applied Physiology, Vol. 77, No. 5, 1994, p. 2440-2448.

Research output: Contribution to journalArticle

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