Pulmonary vascular distensibility of arterial, middle, and venous regions in newborn lambs

Abstract

The pulmonary circulation in the adult is characterized by being relatively distensible, but whether the newborn lung shares this feature is less certain. We perfused isolated lungs treated with indomethacin from lambs of four ages (less than 1, 2-4, 12-14, and 30-32 days) to determine the effects of increasing left atrial pressure on the pulmonary vascular pressures measured by vascular inflow and outflow occlusion. An index of pulmonary vascular distensibility was assessed by comparing the slope of the pulmonary vascular pressure at the upstream end of a region as a function of the pressure at the downstream end of the region. A vascular distensibility index (VDI) of 1 indicates a rigid nondistensible system, whereas a VDI less than 1 indicates some degree of distensibility. During normoxia, lungs from all age groups were relatively indistensible as determined by VDI for the total vasculature (VDItotal) as well as for the different regions based on occlusion pressures (VDIarterial, VDImiddle, and VDIvenous). There were significant effects of age on the VDItotal, with decreases in the normoxic values occurring over the first 12-14 days of age, indicating an increase in pulmonary vascular distensibility. Only the VDIvenous was similarly affected by increasing neonatal age. Hypoxia significantly reduced the VDItotal in these same age groups. In addition, hypoxia, which increased the pressure gradients of the arterial and middle regions, significantly increased the VDIarterial in the youngest and oldest age groups but significantly decreased the VDImiddle at all ages by approximately 50%. In summary, we observed age-related changes in the vascular distensibility of the pulmonary circulation, with the VDItotal decreasing with increasing postnatal age.(ABSTRACT TRUNCATED AT 250 WORDS)