Effect of Parenchymal Stiffness on Canine Airway Size with Lung Inflation 英文参考文献.docVIP

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Effect of Parenchymal Stiffness on Canine Airway Size with Lung Inflation 英文参考文献.doc

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Effect of Parenchymal Stiffness on Canine Airway Size with Lung Inflation 英文参考文献

EffectofParenchymalStiffnessonCanineAirwaySize withLungInflation RobertH.Brown1,2,3,DavidW.Kaczka1,4,WayneMitzner2,4 * 1Department ofAnesthesiologyandCriticalCareMedicine,JohnsHopkins University, Baltimore,Maryland,United StatesofAmerica, 2DepartmentofEnvironmental Health Sciences, Johns Hopkins University, Baltimore, Maryland,United States ofAmerica, 3Department of Radiology, JohnsHopkins University, Baltimore, Maryland, UnitedStatesofAmerica,4DepartmentofBiomedicalEngineering,JohnsHopkinsUniversity,Baltimore,Maryland,UnitedStatesofAmerica Abstract Althoughairwaypatencyispartiallymaintainedbyparenchymaltethering,thisstructuralsupportisoftenignoredinmany discussions of asthma. However, agonists that induce smooth muscle contraction also stiffen the parenchyma, so such parenchymalstiffeningmayserveasadefensemechanismtopreventairwaynarrowingorclosure.Toquantifythiseffect, specificallyhowchangesinparenchymalstiffnessalterairwaysizeatdifferentlevelsoflunginflation,inthepresentstudy, wedevisedamethodtoseparatetheeffectofparenchymalstiffeningfromthatofdirectairwaynarrowing.Sixanesthetized dogs were studied under four conditions: baseline, after whole lung aerosol histamine challenge, after local airway histamine challenge, and after complete relaxation of the airways. In each of these conditions, we used High resolution ComputedTomographytomeasureairwaysizeandlungvolumeatfivedifferentairwaypressures(0,12,25,32,and45cm H2O). Parenchymal stiffening had a protective effect on airway narrowing, a fact that may be important in the airway responsetodeepinspirationinasthma.Whentheparenchymawasstiffenedbywholelungaerosolhistaminechallenge,at everylungvolumeaboveFRC,theairwayswerelargerthanwhentheyweredirectlychallengedwithhistaminetothesame initialconstriction.Theseresultsshowforthefirsttimethatastiffparenchymaperseminimizestheairwaynarrowingthat occurs with histamine challenge at any lung volume. Thus in clinical asthma, it is not simply increased airway smooth musclecont