Leistungsbegrenzung von seiten der Lunge: Band 5 Verhandlungen der Gesellschaft für Lungen- und Atmungsforschung Tagung 5./6. Dezember 1976

274 Pages·1976·12.473 MB·German

by  Professor Dr. Heinz Bartels (auth.), Wolfgang T. Ulmer (eds.)

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© by Springer-Verlag Berlin-Heidelberg 1976
Originally published by Springer-Verlag Berlin Heidelberg in 1976
IN HALT /CONTENTS
SUPPLEMENT 1976
Leistungsbegrenzung von seiten der Lunge
Band 5 Verhandlungen der Gesellschaft fiir Lungen-und Atmungsforschung
Tagung 5.16. Dezember 1976
Herausgegeben von W. T. Ulmer, Bochum
H. Bartels: Comperative Aspects of Respiration D. Berger, D. Nolte: Akupunktur bei Bronchial
and Circulation in Mammals 1 obstruktion - Bodyplethysmographische MeB
ergebnisse 145
G. Grimby: Respiration as a Limiting Factor
for Working Capacity 11 M. Debelic, B. Wuthrich, P. Radielovic:
Protektive Medikamentenwirkung bei antigen
H. Matthys: Die Lunge als leistungsbegrenzen induziertem Bronchialasthma 153
der Faktor bei Patienten: Blutgase 17
G. Schultze-Werninghaus, E. Gonsior,
R. Keller, C. Kopp, W. Zutter, J. Mlczoch, J. Meier-Sydow: Broncholytic und Protective
H. Herzog: Der Lungenkreislauf als Effects of Antiallergic Drugs in Allergen
leistungsbegrenzender Faktor bei Patienten 27 Inhalation Tests 161
M. Beil: Leistungsbegrenzung durch Storungen P. Endres, K. H. Schnabel, R. Ferlinz: Die
der Atemmechanik 41 Beeinflussung des Plasmas cAMP durch
inhalative und parenterale ,82-adrenerge
D. Nolte: Therapiemoglichkeiten bei Stimulatoren 171
Leistungsbegrenzung von seiten der Lunge:
Rehabilitation chronischer Stadien 61 P.-P. Heusinger: Die theoretische
Ventilationsleistung der Lunge,
U. Smidt, G. Worth: Begutachtungsgrundlagen Diagrammdarstellung. Vergleich mit der
fi.ir die Leistungsbegrenzung von seiten der physiologischen Interpretation 177
Lunge 75
W. Wierich: Die Ventilationsleistung isolierter
H. H. Marx, H. Erwes: Zur Objektivierung der Lungen in verschiedenen Lebensaltern unter
pulmonalen Leistungsgrenze 97 Berucksichtigung verschiedener Auswertungs
methoden, speziell unter Anwendung der
N. Konietzko, H. Schlehe, K. H. Ruhle, J. Methode nach Heusinger 183
Brandstetter, H. Matthys: Kardiopulmonale
Funktionsstorungen in Ruhe und unter G. Goeckenjan, P. Schneider, J. Heiden
korperlicher Belastung bei Patienten mit reich: Kontinuierliche Messung des
einseitiger Pleuraschwarte 105 gemischt-venosen Sauerstoffpartialdrucks
mittels einer Katheterelektrode 193
R. Meister, H.·W. Klempt: Atemfunktion und
Lungenkreislauf bei thorakaler ,Fesselung" der M. Meyer, H. Magnussen: A Modified
Lunge 115 Rebreathing Technique for Estimating Pul
monary 02 Diffusing Capacity in Man During
H. Lollgen, F. H. Hertle: Interpretation of Exercise 201
Pulmonary Function by Means of the Pulmonary
R. Goerg, S. Daum: Adaption der
Age Equivalent (PAE) 125
Lungenperfusion an die Okklusion eines
L. Kuhner: Atemreserve und Arbeitsatem Hauptastes der Arteria pulmonalis 205
minutenvolumen als atemmechanische
H. Worth, H. Takahashi, J. Piiper: Pulmonaler
leistungsbegrenzende Faktoren 133
Gasaustausch nach Ersatz des Luftstickstoffs
durch andere inerte Gase 213
K. Hochstra6er, B. Rasche, C. Mieten, K.
Schorn, C. E. von Pilar, A. Bum: Der humorale W. Schwarz, H. Fabel: Das arterielle
lnter-alpha-trypsininhibitor als lnhibitogen fi.ir Sauerstoffpartialdruckprofil unter Belastung und
sekretorische Proteaseinhibitoren. in der Erholungsphase-fortlaufende
Serumkonzentrationen bei Erwachsenen und Sauerstoffpartialdruckmessungen bei
bei Kindern mit Atemwegserkrankungen 137 Lungengesunden und bei Bronchitikern 217
S. Kunke, V. Schulz, W. Erdmann, K. H. M. Meyer, H. Magnussen: A Modified
Schnabel: A System of Pao Continuously Rebreathing Technique for Estimating Pul
Controlled Ventilation 229' monary 02 Diffusing Capacity in Man During
Exercise 201
K. Diether, W. K. R. Barnlkol: Ober die
klinische Anwendbarkeit der Methode des R. Goerg, S. Daum: Adaption der
Totluftplateaus zur Messung des anatomischen Lungenperfusion an die Okklusion eines
Totraumes 233 Hauptastes der Arteria pulmonalis 205
M. Reinert, D. Heise, W. Mall, F. Tren H. Worth, H. Takahashi, J. Pllper: Pulmonaler
delenburg: Zum Problem der herzsynchronen Gasaustausch nach Ersatz des Luftstickstoffs
Partialdruckschwankungen von durch andere inerte Gase 213
Atemgasen 241
W. Schwarz, H. Fabel: Das arterielle
Sauerstoffpartialdruckprofil unter Belastung und
A. Bouhuys: Experimental Studies on Airway
in der Erholungsphase-fortlaufende
Smooth Muscle Responses 249
Sauerstoffpartialdruckmessungen bei
Lungengesunden und bei Bronchitikern 217
K. Lanser, E. Kaukel, V. Sill:
Reflektorische und lokal-irridativ induzierte
S. Kunke, V. Schulz, W. Erdmann, K. H.
Bronchokonstriktion 253
Schnabel: A System of Pa02 Continuously
Controlled Ventilation 229
E. Vastag, K. Vass, L. Nagy: Broncho
constriction Reflex in Bronchial Asthma 259 K. Dlelher, W. K. R. Barnikol: Ober die
klinische Anwendbarkeit der Methode des
J. lravani, G. N. Melville, H.-G. Richter: Totluftplateaus zur Messung des anatomischen
Mucus Production Influenced by Drugs: Totraumes 233
An Electron Microscopic Study 267
M. Reinert, D. Heise, W. Mall, F. Tren
J. Ahrens: Theophylline Blood Levels with delenburg: Zum Problem der herzsynchronen
Partialdruckschwankungen von
Theophylline Ethylene Diamine 275
Atemgasen 241
P. Wylicil, M. Beil, E. Herrmann: Die Analyse
A. Bouhuys: Experimental Studies on Airway
belastungsabhangiger Storungen der Atem
Smooth Muscle Responses 249
mechanik mit Ergo-Bodyplethysmo-
graphie 279
K. Lanser, E. Kaukel, V. Sill:
Reflektorische und lokal-irridativ induzierte
J. Pliper, F. Adaro: Importance of Strati Bronchokonstriktion 253
ficationallnhomogenity for Pulmonary Gas
Exchange 285 E. Vastag, K. Vass, L. Nagy: Broncho
constriction Reflex in Bronchial Asthma 259
P.-P. Heusinger: Die theoretische
J. lravanl, G. N. Melville, H.-G. Richter:
Ventilationsleistung der Lunge,
Mucus Production Influenced by Drugs:
Diagrammdarstellung. Vergleich mit der
An Electron Microscopic Study 267
physiologischen Interpretation 1n
J. Ahrens: Theophylline Blood Levels with
W. Wierich: Die Ventilationsleistung isolierter
Theophylline Ethylene Diamine 275
Lungen in verschiedenen Lebensaltern unter
BerUcksichtigung verschiedener Auswertungs
P. Wyllcll, M. Bell, E. Herrmann: Die Analyse
methoden, speziell unter Anwendung der
belastungsabhangiger Storungen der Atem
Methode nach Heusinger 183
mechanik mit Ergo-Bodyplethysmo-
graphie 279
G. Goeckenjan, P. Schneider, J. Heiden
reich: Kontinuierliche Messung des J. Pilper, F. Adaro: Importance of Strati
gemischt-venosen Sauerstoffpartialdrucks ficationallnhomogenity for Pulmonary Gas
mittels einer Katheterelektrode 193 Exchange 285
Pneumonologie Suppl. 1976, 1-9
©by Springer-Verlag 1976
Comparative Aspects of Respiration and Circulation
in Mammals
Heinz Bartels
Institut fiir Physiologie, Medizinische Hochschule Hannover
A b s tract. Adaptational mechanisms concerning the higher metabolic
rate in small mammals compared to big ones are discussed. The alveolar
gas exchange area is relatively larger in small mammals, because the in
dividual alveoli are smaller. The capillarization of muscle tissue is higher
in small mammals like mice and small bats. Ventilation and cardiac index
increase in correlation to metabolic rate. Blood oxygen affinity is lower
in small mammals supporting oxygen delivery into tissue. From the point
of view of comparative respiratory and circulatory physiology man has all
the biological advantages to be "average".
Key words: Alveoli - Capillarization - Gas diffusion - Cardiac index -
Ventilation -Oxygen affinity - Bohr effect - Altitude - 2, 3-diphosphoglyce
rate - Cytochrome oxidase - Camel - Llama - Elephant - Bat - Mouse
The board of the Society of Lungen- und Atmungsforschung decided last
year to confront its members with the aspects of comparative physiology
of respiration and circulation, because it was thought it might sometimes
be necessary to remember that man is only one page in the large book of
nature.
This seems to be also in good agreement with the topic of our meeting
this year, because the main point of this discussion will deal with the fact
that small animals consume more oxygen per unit of tissue than large ani
mals. We will try to understand how nature solved this problem although
the anatomical similarity in a relatively uniform class like the mammals
is most remarkable. Figure 1 illustrates the problem, if we look at the
metabolic rate of the elephant on the one hand and that of the shrew on the
other. The shrew has almost a hundredfold higher oxygen consumption per
kg and min compared to the elephant.
In order to understand how nature met these very different metabolic
needs we have to consider morphologic and functional adaptations.
A. Morphological adaptations may concern: (1) the lung volume,
(2) the alveolar gas exchange area, (3) the diffusion distance from alveolar
gas into capillary blood of the lung, (4) the heart' s adjustment to required
2
• Shrew
.
' '
Bot ' • Mouse
'
'
'
c . '
'
E ,•Bat -..... ',
Qj .....
',Mouse '
a_ ' ' ,
WJ .
..::.:: G'Uineo-pig ' ,
aQ_j 10 Rat' •, Monkey•. •00' ;;-,
E ' ' ',•RCaab bit » ' '• p' . •Whole
'-.... Goat• orporse
N ' '
0 ' Pig. .ltorse
' ..... '
Be~r•Man • Cow .',
\!onotee~lephant
'
'• Oug,o,ng
'
103 104 105
g body weight
Fig. 1. Metabolic rate (ml 0 2 per kg per min) as function of body weight
(After Bartels, 1964)
cardiac output, and (5) the capillarization of the tissue with respect to the
exchange are between blood and tissue.
1. The lung volume is, as Figure 2 shows, obviously not correlated
to metabolic rate but to body weight representing on the average 8 volume
percent of the total body volume.
2. The a 1 v eo l a r g a s e x c hang e on the other hand is very well adapt
ed to higher metabolic rates (Fig. 3). The higher the metabolic rate, the
smaller the alveolar diameter, thus increasing the exchange area marked
ly. Fick' s diffusion equation in the simplified form shows that exchange
area (A) is directly proportional to the exchanged amount of gas (Vo2) per
time unit, other factors (diffusion constant D and distanced, gas concen
tration difference C1 - C2) being constant:
A
V0 2 = D d (Cl - C2).
3. The diffusion di stance is not yet reported to be reduced in smal
ler mammals.
3
Elephant
100 X 10000
Dugong hale
Manatee, • Horse
e X
10 Bear. • Cow 1000
Pig • Porpoise
__J Goat • Man
Ol
EC1J Racca an •D og • 100 E
~ Cot Ol
>0 Rabbit • ~ Monkey C1J
~
Ol 0.1 Marmot...-:;; Armadillo 10 .....
c 0
:::J
_J C1J
• I
0.01 - 1.0 )(
0.001 0.1
0.0001 L...__..J....__....L.__ ___l_ _. ..J__-L-_ _,J
0.01 0.1 1.0 10 100 1000 10 000
kg body weight
Fig. 2. Logarithmic plot of lung volume as function of body weight (After
Tenney and Remmers, 1963)
10000~---------------~
Manatee
• Dugong
:i_ 1000
....
C1J
(i;
E Porpoise
a
""0 Whole • Ra;coon Monkey
....
Be~ r • '•cat.e.Goot
0 100
Ptg •Cow: ~W!!odchuck
0
<1> Armadtllo • Dog j e-Rat
>
<( Rabbit • Gutneo-ptg
'Mouse Shrew
~·Bat
10~-L~~~L__...J_...J~~~~~~~~
10 100 1000 10 000
Vo2 ( ml per kg per hr)
Fig. 3. Mean alveolar diameter as function of metabolic rate (After Tenney
and Remmers, 1963)
4
Fig. 4. Body weight as
106 - - function of capillaries
• Cow
per sq mm in gastro
105 -
ePig - cnemius muscle (After
Schmidt-Nielsen and
E •Sheep
.!2'> 104 f- Robb it - Pennycuik, 1961)
aJ
3: • Cot
•
">0- 103 f- • Guinea-pig
0
..0 • Rot
Ol 102 - -
• Mouse
101 f- .Bot
I I I I
100 500 1000 1500
Capillaries ( per sq.mm)
4. The heart size is, like the lung volume, on the average not correlat
ed to metabolic rate.
5. The cap ill ariz at ion of muscular tissue shows adaptation only in
quite small animals, like mice and small bats (Fig. 4).
B. Fun c tiona l ad apt at ions should be related to (1) ventilation, (2)
diffusion, (3) perfusion, (4) gas transport in blood, and (5) activities of
metabolic enzymes in tissues.
1. Venti 1 at ion. There is no complete information on alveolar or total
ventilation over a sufficient wide weight range in mammals, but breathing
frequences are known (Fig. 5) and show an inverse correlation to body
weight, suggesting that animals with a high metabolic rate have a higher
pulmonary ventilation.
It is interesting that in large animals with low breathing frequences the
functional residual capacity is proportionally larger than in small animals,
thus avoiding an increase of alveolar and arterial oxygen and carbon di
oxide pressure fluctuation during breathing. The net energy cost of breath
ing can be calculated and it is quite obvious that the small mammal spends
more energy for breathing per kg body weight than does a large animal. But
as the metabolic rate is higher in the small species compared to larger
ones, small and large animals spend practically the same percentage of
their total metabolism for breathing.
2. D iff i.1 s ion capacity of the lung is increased by the relative increase
of the exchange area in the lung. The same should be true at the tissue
level, for mice and small bats due to the higher capillary density.
3. Perf u s ion of the lung should be increased in small animals to trans
port the exchanged gases. Figure 5 shows the higher heart frequences and
Figure 6 the increased cardiac index (ml blood per min and kg body weight)
supporting our reasoning.
5
Fig. 5. Metabolic rate
Breaths per min as function of frequen
10 100 cies of respiration and
100r------.----------------~--~ heart rate, respective
ly (After Bartels, 1964)
•
,"'
c:
E "' "'
"'
Q; "'
CL ,"' "'
01
~.._ 10 - /;I'
• Oog • Rot
<I>
CL
Cot • /' o Cot
E 8r eo tn~ S _, ,/ Rabbit
;I'
N Horse "'"' Horse
0 • ;I' 0
"'.( •Man
"' Cow
• Elephant
per min
Fig. 6. Cardiac index
as function of body
c:
weight (After Bartels,
E 240
Qj 1966)
a.
01200
.:><:
......
::l
a.
::; 80
0
u
0 40 • Elephant
"0
0
u
0.1 10
kg ·body weight
4. Oxygen transport in blood can be enhanced by increasing (a)
the hem o g 1 obi n con centra t ion, the uptake and unloading capacity
(expressed by) (b) oxygen affinity, and (c) the Bohr effect.
6
a) Hemoglobin concentration is not well correlated to body weight,
but there is a small tendency toward an inverse correlation to body weight.
An increase of hematocrit above 50o/o would increase blood viscosity and
therefore need increased heart work. In a quite specialized mammalian
family, the tylopodae (camels and llamas), a relatively high hemoglobin
concentration is present together with a low hematocrit due to the excep
tionally high hemoglobin concentration of 45o/o in the ovalocytes. This spe
cial shape of red cells may perhaps facilitate heart work by a lower viscos
ity and enable these species to live under high altitude conditions, which is
true for llamas but also for camels living up to 45 00 m of altitude in Af
ghanistan. These properties persist in tylopodae, when living on sea level,
probably due to their genetic basis.
b) Oxygen affinity showsafairlygoodcorrelationtobodyweight
(Fig. 7) suggesting that mammals with a high metabolic rate need a high
unloading tension for sufficient oxygen supply into their tissues. Special
ecolpgic conditions, like diving and high altitude also seem to be related
to the oxygen affinity. Small rodents native to high altitude have higher oxy
gen affinities (guinea pig) compared to their low land relatives of approxi
mately the same body weight. The same is true for bird species. The Ti
betan goose is reported to fly up to 10, 000 m crossing the Himalayas in
fall and spring. Though the heme group of the hemoglobin molecule is the
same in all species so far considered, there are different, now fairly well
known mechanisms, which establish different oxygen affinities in mammals
• Bat
40
Hedg~hog • Cot
35 Sheep
rNf •
Rabbit Cow
I Cl 30 •..........._ Dog G.oat Pig •
E Golden hamster -...........
E ~·a~
• Guin.ea-pig
25
+Mole 11 ~
L.'1l _am__a_• Camel
Elephant•
20
103 104
g body weight
Fig. 7. Half-saturation oxygen tension (blood pH 7. 4, 37°C) as function of
body weight