Effect of acute alterations of blood volume on circulatory performance in humans

Abstract

We produced left lower lobe (LLL) pneumococcal pneumonia in seven dogs and measured lung volumes and pulmonary mechanics before (day 1) and 48 h after (day 3) development of the infection. Compared with seven control dogs, total lung capacity (TLC) and functional residual capacity (FRC) decreased 550 and 140 ml, respectively, representing a 15% reduction from the initial value in both cases. Compliance measured during tidal breathing decreased by 30%, and even when corrected for the smaller FRC on day 3, specific compliance (CLsp) was reduced. At autopsy, the infected LLL had an excess weight of 89 g, and its 50% reduction in gas volume accounted for the decrease in TLC from day 1 to day 3. Compared with control dogs, there were no changes in the deflation pressure-volume curves of the noninfected lung of the pneumonia dogs. These results indicate that the reduction in TLC in bacterial lobar pneumonia was small and resulted from the reduced gas volume of the infected lobe. Assuming that the increased weight gain in the LLL represented 89 ml of exudate that filled alveoli, we propose that bacterial pneumonia reduced gas volume at FRC by filling alveoli with inflammatory exudate and further decreased TLC by preventing these alveoli from inflating. The reduced CLsp suggested nonventilation of air spaces in addition to those that were liquid filled and was consistent with nonventilation of the entire LLL.