Effects of lung volume and positive airway pressure on collateral resistance

Abstract

Nine mongrel dogs were anesthetized, paralysed, ventilated, and placed in an iron lung. Each animal was transiently connected to a spirometer and the respiratory system compliance measured by applying negative or positive extrathoracic pressures (from −20 cm H 2O to +20 cm H 2O in 5 cm H 2O steps). A sub-lobar bronchus was wedged with a 5.5 mm bronchoscope, and a 5f Swan-Ganz catheter was inserted into the lumen of the bronchoscope; one port served to introduce a 200 ml·min −1 flow of 5% CO 2 in air, the other to measure the pressure in the wedged segment. Rcoll was measured with extrathoracic pressures in the iron lung ranging from 0 to −20 cm H 2O (NEP) and 0 to +20 cm H 2O (PEP) in 5 cm H 2O steps, and under expiratory positive airway pressure (EPAP) of 5, 10, 15, and 20 cm H 2O. The maximal changes in FRC were an increase of 1009±49ml (mean ± SEM) with NEP and a decrease of 397±33 ml with PEP. Increasing FRC decreased Rcoll while decreasing FRC markedly increased it. EPAP induced similar decreases in Rcoll as NEP of equal pressure. This effect of EPAP was inhibited by simultaneously applying PEP of equal pressure. We conclude that resistance to collateral flow is highly dependent on lung volume, and that positive airway pressure decreases Rcoll by its effects on lung volume.