Site of Airway Obstruction after Rapid Saline Infusion in Healthy Subjects

Rolla, Giovanni; Bucca, Caterina; Polizzi, S.; Giachino, O.; Maina, AW; Arossa, W; Spinaci, Stefano

doi:10.1159/000194533

Cited by 6 publications

(7 citation statements)

References 13 publications

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“…This pattern of lung function abnormalities points to a small airway dysfunction. From a similar normal saline infusion in normal men, Muir et al [ 11 ], Collins et al [3] and Rolla et al [14] reported abnormalities of lung function tests more specific for small air way dysfunction. All these authors agree that such functional changes could be caused by interstitial lung edema.…”

Section: Discussionmentioning

confidence: 98%

“…In the present study 5 healthy male sub jects were challenged with methacholine inhalation in order to compare the provo cation doses producing a 35% fall in spe cific airway conductance (PDjjSGaw) be fore and after rapid saline infusion, a safe experimental method which has been sug gested to induce minimal interstitial lung edema [3,11,14],…”

Section: Introductionmentioning

confidence: 99%

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Methacholine Inhalation Challenge after Rapid Saline Infusion in Healthy Subjects

et al. 1986

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Five healthy subjects were challenged with methacholine on 2 different days, 1 week apart, the second day after acute intravenous 30 ml/kg 0.9% saline infusion. After infusion, we observed a significant reduction in vital capacity (VC), maximal expiratory volume in 1 s (FEV₁), provocation dose producing a 35% fall in SG_aw(PD₃₅SG_aw) and in 25% of maximal expiratory flow (MEF25), and an increase in the slopes of log dose-response curves. Our results suggest an increased bronchial reactivity in acute minimal interstitial lung edema.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Methacholine Inhalation Challenge after Rapid Saline Infusion in Healthy Subjects

et al. 1986

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“…They speculated that the second phase was due to either peribronchial or airway oedema formation. Finally, ROLLA et al [4] rapidly infused NS into human volunteers and found that small airway resistance increased. They suggested that pulmonary interstitial oedema developed during volume loading.…”

Section: Discussionmentioning

confidence: 99%

“…Pulmonary congestion, resulting from either poor left ventricular function [1][2][3] or rapid volume loading [4], will impair pulmonary function. Increases in airway resistance both in human and animal studies are reported to be more prominent in small rather than large airways [2][3][4][5][6].…”

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confidence: 99%

The role of submucosal oedema in increased peripheral airway resistance by intravenous volume loading in dogs

Freed

1994

Eur Respir J

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Pulmonary congestion leads to an increase in airway resistance. It is still unknown whether this is due to vascular engorgement or to submucosal oedema. The present study was designed to determine the relative contribution of these two potential mechanisms. We examined the effect of intravenous volume loading on canine peripheral airway resistance (Rp). Bronchoscopes were wedged in contralateral sublobar segments and used to record Rp during rapid infusion of normal saline. Volume loading with normal saline increased pulmonary capillary wedge pressure (PCWP) and Rp. Unlike normal saline, dextran 70 did not increase Rp when infused at a rate that produced similar changes in PCWP. During infusion of normal saline, delta Rp was significantly enhanced in lung segments previously challenged with dry air when compared to contralateral control lungs, unexposed to dry air, and the use of dextran 70 significantly reduced this effect. Vasoconstriction with phenylephrine significantly decreased baseline Rp, but did not completely reverse the effect of fluid infusion. In addition, in lung segments exposed to dry air, delta Rp was significantly greater after volume loading and treatment with phenylephrine when compared to contralateral control lung. Finally, muscarinic receptor blockade was ineffective in preventing Rp from increasing during infusion of normal saline. Our results suggest that volume loading-induced increases in Rp are not caused by either vascular engorgement or the stimulation of muscarinic receptors.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…These abnormalities presumably develop via a combination of external airway compression from a dilated pulmonary circulation and internal bronchial narrowing secondary to mucosal oedema from an overloaded bronchial vascular tree (Hughes et al 1957;Saxton et al 1965;Tattersfield et al 1972). While we did not measure central haemodynamics directly in the present investigation, several studies in man employing rapid administration (15-30 ml/kg bwt over a 15-20 min period) of saline have demonstrated intravascular volume expansion to occur without alterations in systemic blood pressure or heart rate (Doyle et al 1951;Rolla et al 1983). In these studies, general and pulmonary blood volumes rose by 14 and 12%, respectively (Doyle et al 1951).…”

Section: Arterial Gas Parametersmentioning

confidence: 71%

Respiratory and metabolic effects of massive administration of isotonic saline solution in heaves‐affected and control horses

Jean

Lavoie

2004

Equine Veterinary Journal

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Summary Reasons for performing study: It has been suggested that rapid administration of isotonic saline solution relieves airway obstruction in heaves‐affected horses, but the efficacy and tolerability of this treatment is poorly documented. Objectives: To determine the respiratory and metabolic effects of a rapid administration of isotonic saline solution in control horses and those with heaves. Methods: Thirty litres isotonic saline solution were administered i.v. to 5 control (Group C) and 9 heaves‐affected horses (Group H). Pulmonary function testing and arterial blood gas analysis were performed prior to saline infusion, at 90 and 180 mins after starting the infusion, and 1, 3, 6 and 10 days later. PCV, plasma total solids, plasma electrolytes (Na+, Cl‐ and K+) and venous blood gas analysis were performed prior, during and after saline infusion. Results: Rapid saline administration was shown to have no beneficial effects on lung function during infusion in Group H. On the contrary, they had significantly increased pulmonary resistance (RL) at 180 mins following the initiation of saline administration compared to baseline. In Group C, saline administration resulted in a significant increase in RL at 180 mins and a significant decrease in PaO2 at 90 mins. These results suggest a transient decrement in lung function caused by rapid saline administration. Group H had a metabolic alkalosis with hypochloraemia at baseline compared to control horses. This resolved following i.v. saline administration and returned to baseline within 6 h after treatment had been discontinued. Conclusion: The administration of saline to Group H did not improve airway function significantly, but resulted in mild and transient side effects. Potential relevance: Rapid administration of isotonic saline alone is not an effective therapy for heaves in horses.

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Site of Airway Obstruction after Rapid Saline Infusion in Healthy Subjects

Cited by 6 publications

References 13 publications

Methacholine Inhalation Challenge after Rapid Saline Infusion in Healthy Subjects

Methacholine Inhalation Challenge after Rapid Saline Infusion in Healthy Subjects

The role of submucosal oedema in increased peripheral airway resistance by intravenous volume loading in dogs

Respiratory and metabolic effects of massive administration of isotonic saline solution in heaves‐affected and control horses

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