Strength of pulmonary vascular response to regional alveolar hypoxia

Regional alveolar hypoxia in the lung induces regional pulmonary vasoconstriction which diverts blood flow from the hypoxic area. However, the predominant determinant of the distribution of perfusion in the normal erect lung is gravity so that more perfusion occurs at the base than at the apex. To determine the strength of the regional alveolar hypoxic response in diverting flow with or against the gravity gradient a divided tracheal cannula was placed in anesthetized dogs and unilateral alveolar hypoxia created by ventilating one lung with nitrogen while ventilating the other lung with oxygen to preserve normal systemic oxygenation. Scintigrams of the distribution of perfusion obtained with intravenous 13N and the MGH positron camera revealed a 34 and 32 percent decrease in perfusion to the hypoxic lung in the supine and erect positions and a 26 percent decrease in the decubitus position with the hypoxic lung dependent (P = 0.94 from supine shift), indicating nearly equal vasoconstriction with shift of perfusion away from the hypoxic lung in all positions. Analysis of regional shifts in perfusion revealed an equal vasoconstrictor response from apex to base in the supine position but a greater response in the lower lung zones in the erect position where perfusion was also greatest