Rodrigues, Ana Claudia M., Moreira, Lucio F. Pacheco, de Souza, Claudia L., Pettersen, Paola Capparelli D., Saldiva, Paulo Hilario N., and Zin, Walter A.
Nineteen rats were sedated, anesthetized, paralyzed, and mechanically ventilated. The respiratory, lung, and chest wall elastances (Est-rs, Est-L, Est-w); respiratory system, pulmonary, and chest wall total resistances (Rtot-rs, Rtot-L, Rtot-w); respiratory system, pulmonary, and chest wall initial resistances (Rinit-rs, Rinit-L, Rinit-w); and respiratory system, pulmonary, and chest wall difference resistances (Rdiff-rs, Rdiff-L, Rdiff-w) were determined before and after thoracotomy using the end-inflation occlusion method. Rinit reflects the Newtonian resistances and Rdiff represents the viscoelastic/inhomogeneous pressure dissipations in the system. Rtot = Rinit + Rdiff, ie, total resistance. The animals were submitted to either anterolateral thoracotomy (group A, n = 7), median sternotomy (group B, n = 6), or median sternotomy under PEEP while the lungs were exposed (group C, n = 6). In groups A and B, statistically significant increases in Rdiff-rs significantly augmented Rtot-rs. The former results were entirely secondary to significant increases in Rdiff-L, which naturally raised Rtot, L. Resistance was not altered in group C rats. Thus, anterolateral thoracotomy and median sternotomy increases Rtot-rs as a consequence of augmented Rdiff-L, but this finding could be prevented by the use of PEEP. Est-rs and Est-L increased in the three groups after surgery. Groups D and E were comprised of four animals each. Both underwent median sternotomy and in group E, PEEP was applied. Histopathologic examination of the lungs demonstrated a higher degree of lung collapse in group D. (Chest 1993; 104:1882-86) Est = elastances; L-lung, Pel = elastic recoil pressures; Pes = esophageal pressure; PL = transpulmonary pressure; Ptr = tracheal pressure; Rdiff = difference resistances; Rinit = initial resistances; rs = respiratory system; Rtot = total resistances; V = flow; Vr = relaxation volume; w = chest wall, Thoracotomy frequently leads to respiratory impairment. Although a few studies on respiratory mechanics related to thoracotomy have been reported, there are some important aspects still unexplored. Most of the previous [...]