Mechanism of decreased blood flow to atelectatic lung.

Abstract

This study examined the relative contribution of passive mechanical forces vs. hypoxic pulmonary vasoconstriction as mechanisms of blood flow reduction through atelectatic canine lung. Selective atelectasis of the left lower lobe caused the electromagnetically measured lobar blood flow to decrease 59% from control levels. Reexpansion and ventilation of the left lower lobe with 95% N2-5% CO2, which should terminate any passive mechanical contribution to the decreased test lobe blood flow, did not cause any significant increase in left lower lobe blood flow. Ventilation of the left lower lobe with 100% O2, which should terminate any hypoxic pulmonary vasoconstriction contribution to the decreased test lobe blood flow, increased blood flow back to levels not significantly different from control. Differences between degree of hypoxia, magnitude of transpulmonary pressure, and absolute pulmonary vascular pressure during left lower lobe atelectasis and ventilation with N2 were considered to be minor influences. I conclude that the mechanism of decreased blood flow to an atelectatic lobe is hypoxic pulmonary vasoconstriction.