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This Article Full Text Full Text (PDF) All Versions of this Article: 576/1/269    most recent jphysiol.2006.112797v1 Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by De Troyer, A. Articles by Leduc, D. Search for Related Content PubMed PubMed Citation Articles by De Troyer, A. Articles by Leduc, D. Related Collections Respiratory

¹ Laboratory of Cardiorespiratory Physiology, Brussels School of Medicine, 1070 Brussels, Belgium
² Chest Service, Erasme University Hospital, 1070 Brussels, Belgium
³ Intensive Care Unit, Saint-Pierre University Hospital, 1000 Brussels, Belgium

After single-lung transplantation (SLT) for emphysema, a hyperinflated (native) lung operates in parallel with a normal (transplanted) lung. The interpulmonary distribution of the changes in pleural pressure (P_pl) during breathing, however, is unknown. To approach the problem, two endotracheal tubes were inserted in the right and left main stem bronchi of anaesthetized dogs, one lung was passively inflated, and the values of inspiratory P_pl over the two lungs were assessed by measuring the changes in airway opening pressure (P_ao) in the two tubes during occluded breaths. With single-lung inflation, P_ao decreased in both lungs, but the decrease in the inflated lung was invariably larger than in the non-inflated lung; when transrespiratory pressure in the inflated lung was set at 30 cmH₂O, P_ao in this lung was 27.7 ± 2.0% of the value of functional residual capacity (FRC), whereas P_ao in the non-inflated lung was 74.4 ± 4.5% (P < 0.001). This difference was abolished after the ventral mediastinal pleura was severed. The ribs in both hemithoraces were displaced cranially with inflation, such that the displacement in the contralateral hemithorax was 75% of that in the ipsilateral hemithorax, and parasternal intercostal activity remained unchanged. These observations suggest that in patients with SLT for emphysema (1) the inspiratory P_pl over the transplanted lung are greater than those over the native lung and (2) this difference results primarily from the greater pressure-generating ability of the inspiratory muscles, in particular the diaphragm, on the transplanted side.

(Received 3 May 2006; accepted after revision 11 July 2006; first published online 13 July 2006)
Corresponding author A. De Troyer: Chest Service, Erasme University Hospital, Route de Lennik, 808, 1070 Brussels, Belgium. Email: a_detroyer{at}yahoo.fr