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British Journal of Anaesthesia, Vol 81, Issue 3 425-429, Copyright © 1998 by The Board of Management and Trustees of the British Journal of Anaesthesia

LABORATORY INVESTIGATIONS

Effects of posture on blood flow diversion by hypoxic pulmonary vasoconstriction in dogs

S. M. Walther, K. B. Domino and M. P. Hlastala
Department of Anaesthesia and Intensive Care, Lasarettet, Norrkoping, Sweden; Department of Anesthesiology, University of Washington, School of Medicine, Seattle, USA; Department of Physiology and Biophysics, and Medicine, University of Washington, School of Medicine, Seattle, USA

We used differential excretion of sulphur hexafluoride from the left and right lung to measure blood flow diversion by hypoxic pulmonary vasoconstriction (HPV) in the prone and supine positions in dogs (n = 9). Gas exchange was assessed using the multiple inert gas elimination technique. Blood flow diversion from the hypoxic (3% oxygen) left lung was mean 70.7 (SD 11.2)% in the supine compared with 57.0 (12.1)% in the prone position (P < 0.02). The supine position was associated with increased perfusion to low VA/Q regions (P < 0.05). The increased flow diversion with hypoxia in the supine position was associated with more ventilation to high VA/Q regions (P < 0.05). We conclude that flow diversion by hypoxic pulmonary vasoconstriction is greater in the supine position. This effect could contribute to the variable response in gas exchange with positioning in patients with ARDS.
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