Pulmonary Circulation Characteristics Low Resistance /Pressure The specific structure(s) primarily responsible for the majority of control of resistance.

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Presentation transcript:

Pulmonary Circulation Characteristics Low Resistance /Pressure The specific structure(s) primarily responsible for the majority of control of resistance in the resting state is controversial. Resistance more evenly distributed, but majority of resistance is normally on the arterial side (upstream) of the capillaries. Thin-walled arterial system (relatively little smooth muscle) Anatomical considerations Vessels are surrounded by bags of gas and flexible interstitial fluid- filled regions No true arterioles?? Alveolar and extra-alveolar vessels respond to conditions differently

Influences on resistance Neural/Humoral: all the same players as in the periphery (but less effective) and a few with more specific actions Serotonin:Arterial side vasoconstriction Histamine:Venular side vaso(veno)constriction ***venous side can become dominant resistance Intravascular Pressure R 1/P Pulmonary Circulation recruitment (primary) distension

Pulmonary Vascular Resistance (cmH 2 O/L min-1) Arterial or Venous Pressure (cm H 2 O) Increasing Arterial Pressure Increasing Venous Pressure Perfusion

Influences on resistance Lung volume Neural/Humoral: all the same players as in the periphery (but less effective) and a few with more specific actions Serotonin:Aretrial side vasoconstriction HistamineVenular side vaso(veno)constriction Intravascular Pressure R 1/P recruitment (primary) Distension ***Thus, cardiac output is considered to be the primary determinant of pulmonary vascular resistance Pulmonary Circulation

120 Vascular Resistance (cmH 2 O/Lmin -1 ) Lung Volume (ml)

Influences on resistance Lung volume Low Volume: extra-alveolar vessels are smaller, capillaries more open High Volume: extra-alveolar vessels are pulled open; capillaries become defromed by stretch (more oval; higher resistance) * Lung volume effects on extra-alveolar vessels is lost with positive pressure ventilation. PO 2 : Local Control Decreased PAO2 PAO2 causes vasoconstriction. Advantage: blood is shunted away from poorly ventilated alveoli. Surrounding Pressure Alveolar Interstitial (<0) Pulmonary Circulation

The Starling Resistor Concept Pulmonary Circulation

Arterial (P a ) Venous (P v ) Alveolar (P A ) Zone 1 P A >P a >P v Zone 2 P a >P A >P v Zone 3 P a >P v >P A Blood Flow Distance Pulmonary Circulation

Pulmonary Artery Pulmonary Capillaries Pulmonary Vein Left Atrium mmHg Pulmonary Arterial Catheter Tracing Left Atrial Pressure Tracing Pulmonary Circulation

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