Abstract
Objective
Single lung inhalation injury causes tissue damage to the contralateral lung. We therefore examined airway blood flow after smoke inhalation in chronic instrumented sheep to get further information about the underlying pathophysiology.
Design/patients
The right lung and lower trachea of 5 animals were smoke-exposed, while their left lung was air-insufflated using a split ventilation technique. Three animals, where both lungs were only air-insufflated, served as controls. Blood flow to the airway was measured using a labeled microsphere technique. All animals were studied for 24 h following smoke inhalation. Then they were sacrificed and their tissues harvested.
Results
The airway blood flow to the smoke-exposed lung was elevated 11-fold immediately after inhalation injury. The bronchial blood flow to the air insufflated lung became significantly elevated 24 h post-smoke, although to a lesser extent. The control animals did not show any changes of bronchial blood flow during the observation time.
Conclusions
Damage to one lung can lead to pathophysiologic changes in the contralateral lung. This response appears to be mediated by hematogenous factors.
Article PDF
Similar content being viewed by others
References
Loick HM, Traber LD, Tokyay R, Linares HA, Prient T, Traber DL (1992) Mechanical alteration of blood flow in smoked and unsmoked areas after inhalation injury. J Appl Physiol 72: 1692–1700
Prien T, Linares HA, Traber LD, Herndon DN, Traber DL (1988) Lack of hematogenous mediated pulmonary injury with smoke inhalation. J Burn Care Rehabil 9:462–466
Charan NB, Turk GM, Dhand R (1984) Gross and subgross anatomy of bronchial circulation in sheep. J Appl Physiol 57:658–664
Lakshminarayan S, Kowalski TF, Kirk W, Graham MM, Butler J (1990) The drainage routes of the bronchial blood flow in anesthetized dogs. Respir Physiol 82:65–73
Magno MG, Fishman AP (1982) Origin, distribution, and blood flow of bronchial circulation in anesthetized sheep. J Appl Physiol 53:272–279
Abdi S, Herndon DN, Traber LD, Ashley KD, Stothert JC, Maguire J, Butler R, Traber DL (1991) Lung edema formation following inhalation injury: role of the bronchial blood flow. J Appl Physiol 71:727–734
Hales CA, Barkin P, Jung W, Quinn D, Lamborghini D, Burke J (1989) Bronchial artery ligation modifies pulmonary edema after exposure to smoke with acrolein. J Appl Physiol 67: 1001–1006
Morris SE, Navaratnam N, Herndon DN (1990) A comparison of effects of thermal injury and smoke inhalation on bacterial translocation. J Trauma 30: 639–643
Loick HM, Traber LD, Stothert JC, Herndon DN, Traber DL (1993) Smoke inhalation increases airway blood flow through a hematogenous mechanism in sheep. Anesth Analg 76:S228
Klausner JM, Paterson IS, Mannick JA, Valeri R, Shepro D, Hechtman HB (1989) Reperfusion pulmonary edema. JAMA 261:1030–1035
Pearce ML, Yamashita J, Beazell J (1965) Measurement of pulmonary edema. Circ Res 16:482–488
Kimura R, Traber LD, Herndorn DN, Linares HA, Lübbesmeyer HJ, Traber DL (1965) Increasing duration of smoke exposure induces more severe lung injury in sheep. J Appl Physiol 64:1107–1113
Walker HI, McLeod CGJ, McManus WF (1981) Experimental inhalation injury in the goat. J Trauma 21:962–964
Guyton AC, Jones CE, Coleman TG (1973) Normal cardiac output and its variations. In: Cardiac Physiology: cardiac output and its regulation. Saunders, Philadelphia, pp 3–20
Wu CH, Traber DL, Cross CE, Herndon DN, Kramer GC (1988) Measurement of bronchial blood flow with radioactive microspheres in awake sheep. J Appl Physiol 65:1131–1139
Baile EM, Nelems JM, Schulzer M, Pare PD (1982) Measurement of regional bronchial arterial blood flow and bronchovascular resistance in dogs. J Appl Physiol 53:1044–1049
Buckberg GD, Luck JC, Payne B, Hoffman JIE, Archie JP, Fixer DE (1971) Some sources of error in measuring regional blood flow with radioactive microspheres. J Appl Physiol 31: 598–604
Stothert J, Traber L, Traber D (1992) Bronchial blood flow measurement using radioactive microspheres. FASEB J 6:A1454
Fogo A, Hakim RC, Sugiura M, Inagami T, Kon V (1990) Severe endothelial injury in a renal transplant patient receiving cyclosporine. Transplantation 49:1190–1192
Ashley KD, Stothert JC, JR, Traber DL, Traber LD, Kramer G, Herndon D (1990) Airway blood flow following light and heavy smoke inhalation injury. Surg Forum 41:293–295
Sugi K, Newald J, Traber LD, Maguire JP, Herndon DN, Schlag G, Traber DL (1988) Smoke inhalation injury causes myocardial depression in sheep. Anesthesiology 69:A111
Isago T, Noshima S, Traber LD, Herndon DN, Traber DL (1991) Analysis of pulmonary microvascular permeability after smoke inhalation. J Appl Physiol 71:1403–1408
Demling RH, Lalonde C (1990) Moderate smoke inhalation produces decreased oxygen delivery, increased oxygen demands, and systemic but not lung parenchymal lipid peroxidation. Surgery 108:544–552
Kilbourn RG, Gross SS, Jubran A, Adams J, Griffith OW, Levi R, Lodato RF (1990) NG-methyl-L-arginine inhibits tumor necrosis factor-induced hypotension: implications for the involvement of nitric oxide. Proc Natl Acad Sci USA 87:3629–3632
Busse R, Mulsch A (1990) Induction of nitric oxide synthase by cytokines in vascular smooth muscle cells. FEBS Lett 275:87–90
Moncada S, Palmer RM, Higgs EA (1988) The discovery of nitric oxide as the endogenous nitrovasodilator. Hypertension 12:365–372
Alving K, Fornheim C, Lundberg JM (1993) Pulmonary effects of endogenous and exogenous nitric oxide in the pig: relation to cigarette smoke inhalation. Br J Pharmacol 110:739–746
McCall TB, Palmer RM, Moncada S (1991) Induction of nitric oxide synthase in rat peritoneal neutrophils and its inhibition by dexamethasone. Eur J Immunol 21:2523–2527
Loick HM, Traber LD, Tokyay R, Theissen JL, Linares HA, Traber DL (1992) The effect of dopamine on pulmonary hemodynamics and tissue damage after inhalation injury in an ovine model. J Burn Care Rehabil 13: 305–315
Quinn DA, Robinson D, Jung W, Hales CA (1990) Role of sulfidopeptide leukotrienes in synthetic smoke inhalation injury in sheep. J Appl Physiol 68:1962–1969
Sakuma I, Gross SS, Levi R (1987) Peptidoleukotrienes induce an endothelium-dependent relaxation of guinea pig main pulmonary artery and thoracic aorta. Prostaglandins 34:685–696
Author information
Authors and Affiliations
Additional information
Supported by grant # GM33324, # HL37411, and grant from the Sealy Smith Foundation and the Shriners of North America
Rights and permissions
About this article
Cite this article
Loick, H.M., Traber, L.D., Stothert, J.C. et al. Smoke inhalation causes a delayed increase in airway blood flow to primarily uninjured lung areas. Intensive Care Med 21, 326–333 (1995). https://doi.org/10.1007/BF01705411
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01705411