Abstract
In 6 BPD (3 to 43 m) measurements of intraesophageal pressure, airflow and tidal volume allowed calculations of total pulmonary resistance (RL) and dynamic compliance (CL). On distinct days for each drug, changes of RL and CL with diuretic,Furosemide (lmg/kg IV), inhaled bronchodilators, Isoproterenol (1:200,.2cc) Atropine (.05mg/kg) were assessed. Each patient was his own control on the following “placebo” day. A two-tailed paired test was used to compare baseline values prior drug study, versus baseline values the following “control” day. The same T test was used to compare change of RL, CL in each group (Furo.,Isop.,Atr.) versus change during control day. Baseline values (n=26) revealed: On 23 instances, RL was between 150% and 450% of the predicted value; CL was below 75% of the predicted value in 5 instances. There was no significant difference in baseline parameters (p> .05) prior drug study versus control day. Diuretic improved CL (p=.01,n=6), sympathomimetic improved RL (p=.07,n=5), parasympatholytic improved CL (p=.06,n=4). The study indicated that BPD had marked alteration in large airway (law) mechanism (RL). Small airway (Saw) function (CL) appeared normal in 13 instances, pointing out that only specific CL per liter of lung volume will assess Saw; however, changes of CL reflected Saw changes. PE and Law bronchospasm appeared coexisting factors in BPD. PE may also contribute to Saw (CL) through a vagal reflex.
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