The effect of acute ventilation-perfusion mismatch on respiratory heat exchange in a porcine model.

<h4>Background</h4>Respiratory heat exchange is an important physiological process occurring in the upper and lower respiratory tract and is usually completed when inspired gases reach the alveoli. Animal and human studies demonstrated that heat exchange can be modulated by altering pulm...

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Autores principales:	Maximilian Edlinger-Stanger, Martin-Hermann Bernardi, Katharina Kovacs, Michael Mascha, Thomas Neugebauer, Stefan Böhme, Nathan Ayoubi, Nico Christofi, James Garry, Neal Fleming, Michael Hiesmayr
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/8aa68550adc44e71bf8ae10cf3008031
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spelling	oai:doaj.org-article:8aa68550adc44e71bf8ae10cf30080312021-12-02T20:09:15ZThe effect of acute ventilation-perfusion mismatch on respiratory heat exchange in a porcine model.1932-620310.1371/journal.pone.0254399https://doaj.org/article/8aa68550adc44e71bf8ae10cf30080312021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0254399https://doaj.org/toc/1932-6203<h4>Background</h4>Respiratory heat exchange is an important physiological process occurring in the upper and lower respiratory tract and is usually completed when inspired gases reach the alveoli. Animal and human studies demonstrated that heat exchange can be modulated by altering pulmonary ventilation and perfusion. The purpose of this study was to examine the effect of acute ventilation-perfusion (V/Q) mismatch on respiratory heat exchange. In clinical practice, monitoring respiratory heat exchange might offer the possibility of real-time tracking of acute V/Q-mismatch.<h4>Methods</h4>In 11 anesthetized, mechanically ventilated pigs, V/Q-mismatch was established by means of four interventions: single lung ventilation, high cardiac output, occlusion of the left pulmonary artery and repeated whole-lung lavage. V/Q-distributions were determined by the multiple inert gas elimination technique (MIGET). Respiratory heat exchange was measured as respiratory enthalpy using the novel, pre-commercial VQm™ monitor (development stage, Rostrum Medical Innovations, Vancouver, CA). According to MIGET, shunt perfusion of low V/Q compartments increased during single lung ventilation, high cardiac output and whole-lung lavage, whereas dead space and ventilation of high V/Q compartments increased during occlusion of the left pulmonary artery and whole-lung lavage.<h4>Results</h4>Bohr dead space increased after pulmonary artery occlusion and whole-lung lavage, venous admixture increased during single lung ventilation and whole-lung lavage, PaO2/FiO2 was decreased during all interventions. MIGET confirmed acute V/Q-mismatch. Respiratory enthalpy did not change significantly despite significant acute V/Q-mismatch.<h4>Conclusion</h4>Clinically relevant V/Q-mismatch does not impair respiratory heat exchange in the absence of additional thermal stressors and may not have clinical utility in the detection of acute changes.Maximilian Edlinger-StangerMartin-Hermann BernardiKatharina KovacsMichael MaschaThomas NeugebauerStefan BöhmeNathan AyoubiNico ChristofiJames GarryNeal FlemingMichael HiesmayrPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0254399 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Maximilian Edlinger-Stanger Martin-Hermann Bernardi Katharina Kovacs Michael Mascha Thomas Neugebauer Stefan Böhme Nathan Ayoubi Nico Christofi James Garry Neal Fleming Michael Hiesmayr The effect of acute ventilation-perfusion mismatch on respiratory heat exchange in a porcine model.
description	<h4>Background</h4>Respiratory heat exchange is an important physiological process occurring in the upper and lower respiratory tract and is usually completed when inspired gases reach the alveoli. Animal and human studies demonstrated that heat exchange can be modulated by altering pulmonary ventilation and perfusion. The purpose of this study was to examine the effect of acute ventilation-perfusion (V/Q) mismatch on respiratory heat exchange. In clinical practice, monitoring respiratory heat exchange might offer the possibility of real-time tracking of acute V/Q-mismatch.<h4>Methods</h4>In 11 anesthetized, mechanically ventilated pigs, V/Q-mismatch was established by means of four interventions: single lung ventilation, high cardiac output, occlusion of the left pulmonary artery and repeated whole-lung lavage. V/Q-distributions were determined by the multiple inert gas elimination technique (MIGET). Respiratory heat exchange was measured as respiratory enthalpy using the novel, pre-commercial VQm™ monitor (development stage, Rostrum Medical Innovations, Vancouver, CA). According to MIGET, shunt perfusion of low V/Q compartments increased during single lung ventilation, high cardiac output and whole-lung lavage, whereas dead space and ventilation of high V/Q compartments increased during occlusion of the left pulmonary artery and whole-lung lavage.<h4>Results</h4>Bohr dead space increased after pulmonary artery occlusion and whole-lung lavage, venous admixture increased during single lung ventilation and whole-lung lavage, PaO2/FiO2 was decreased during all interventions. MIGET confirmed acute V/Q-mismatch. Respiratory enthalpy did not change significantly despite significant acute V/Q-mismatch.<h4>Conclusion</h4>Clinically relevant V/Q-mismatch does not impair respiratory heat exchange in the absence of additional thermal stressors and may not have clinical utility in the detection of acute changes.
format	article
author	Maximilian Edlinger-Stanger Martin-Hermann Bernardi Katharina Kovacs Michael Mascha Thomas Neugebauer Stefan Böhme Nathan Ayoubi Nico Christofi James Garry Neal Fleming Michael Hiesmayr
author_facet	Maximilian Edlinger-Stanger Martin-Hermann Bernardi Katharina Kovacs Michael Mascha Thomas Neugebauer Stefan Böhme Nathan Ayoubi Nico Christofi James Garry Neal Fleming Michael Hiesmayr
author_sort	Maximilian Edlinger-Stanger
title	The effect of acute ventilation-perfusion mismatch on respiratory heat exchange in a porcine model.
title_short	The effect of acute ventilation-perfusion mismatch on respiratory heat exchange in a porcine model.
title_full	The effect of acute ventilation-perfusion mismatch on respiratory heat exchange in a porcine model.
title_fullStr	The effect of acute ventilation-perfusion mismatch on respiratory heat exchange in a porcine model.
title_full_unstemmed	The effect of acute ventilation-perfusion mismatch on respiratory heat exchange in a porcine model.
title_sort	effect of acute ventilation-perfusion mismatch on respiratory heat exchange in a porcine model.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/8aa68550adc44e71bf8ae10cf3008031
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The effect of acute ventilation-perfusion mismatch on respiratory heat exchange in a porcine model.

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