Topographical distribution of pulmonary perfusion and ventilation, assessed by PET in supine and prone humans

Guido Musch, J. Dominick H. Layfield, R. Scott Harris, Marcos F. Vidal Melo, Tilo Winkler, Ronald J. Callahan, Alan J. Fischman, Jose G. Venegas

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155 Scopus citations

Abstract

Using positron emission tomography (PET) and intravenously injected 13N2, we assessed the topographical distribution of pulmonary perfusion (Q̇) and ventilation (V̇) in six healthy, spontaneously breathing subjects in the supine and prone position. In this technique, the intrapulmonary distribution of 13N2, measured during a short apnea, is proportional to regional Q̇. After resumption of breathing, regional specific alveolar V̇ (sV̇A, ventilation per unit of alveolar gas volume) can be calculated from the tracer washout rate. The PET scanner imaged 15 contiguous, 6-mm-thick, slices of lung. Vertical gradients of Q̇ and sV̇A were computed by linear regression, and spatial heterogeneity was assessed from the squared coefficient of variation (CV2). Both CV2 and CVsV̇A2 were corrected for the estimated contribution of random imaging noise. We found that 1) both Q̇ and V̇ had vertical gradients favoring dependent lung regions, 2) vertical gradients were similar in the supine and prone position and explained, on average, 24% of Q̇ heterogeneity and 8% of V̇ heterogeneity, 3) CV2 was similar in the supine and prone position, and 4) CVsV̇A2 was lower in the SVA prone position. We conclude that, in recumbent, spontaneously breathing humans, 1) vertical gradients favoring dependent lung regions explain a significant fraction of heterogeneity, especially of Q̇, and 2) although Q̇ does not seem to be systematically more homogeneous in the prone position, differences in individual behaviors may make the prone position advantageous, in terms of V̇-to-Q̇ matching, in selected subjects.

Original languageEnglish
Pages (from-to)1841-1851
Number of pages11
JournalJournal of Applied Physiology
Volume93
Issue number5
DOIs
StatePublished - Nov 1 2002
Externally publishedYes

Keywords

  • Functional lung imaging
  • Gas exchange
  • Heterogeneity
  • Positron emission tomography
  • Prone position

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    Musch, G., Layfield, J. D. H., Harris, R. S., Vidal Melo, M. F., Winkler, T., Callahan, R. J., Fischman, A. J., & Venegas, J. G. (2002). Topographical distribution of pulmonary perfusion and ventilation, assessed by PET in supine and prone humans. Journal of Applied Physiology, 93(5), 1841-1851. https://doi.org/10.1152/japplphysiol.00223.2002