PVR is the resistance to flow that must be
overcome to push blood through the lungs.
Any change in the viscosity of blood (such
as due to a change in hematocrit) would also affect the measured vascular
resistance. There are many factors that alter the vascular resistance. Many of
the platelet-derived substances, including serotonin, are vasodilatory when the
endothelium is intact and are vasoconstrictive when the endothelium is damaged.
Cholinergic stimulation causes release of
endothelium-derived relaxing factor (EDRF) (later it was discovered that EDRF
was nitric oxide) from intact endothelium, causing vasodilation. If the
endothelium is damaged, cholinergic stimulation causes vasoconstriction.
The major determinant of vascular resistance is small arteriolar (known
as resistance arterioles) tone. These vessels are from 450 μm down to 100 μm in
diameter (as a comparison, the diameter of a capillary is about 5 to
10 μm). Another determinant of vascular resistance is the pre-capillary arterioles. These arterioles are less than 100 μm in
diameter. They are sometimes known as autoregulatory vessels since they can
dynamically change in diameter to increase or reduce blood flow
Any change in the viscosity of blood (such as due
to a change in hematocrit) would also affect the measured vascular resistance.
Pulmonary vascular resistance (PVR) also depends on
the lung volume, and PVR is lowest at the functional residual capacity (FRC). The highly compliant nature of the
pulmonary circulation means that the degree of lung distention has a large
effect on PVR. This results primarily due to effects on the alveolar and
extra-alveolar vessels. During inspiration, increased lung volumes cause
alveolar expansion and lengthwise stretching of the interstitial alveolar
vessels. This increases their length and reduces their diameter, thus
increasing alveolar vessel resistance. On the other hand, decreased lung
volumes during expiration cause the extra-alveolar arteries and veins to become
narrower due to decreased radial traction from adjacent tissues. This leads to
an increase in extra-alveolar vessel resistance. PVR is calculated as a sum of
the alveolar and extra-alveolar resistances as these vessels lie in series with
each other. Because the alveolar and extra-alveolar resistances are increased
at high and low lung volumes respectively, the total PVR takes the shape of a U
curve. The point at which PVR is the lowest is near the FRC.
References:
http://en.wikipedia.org/wiki/Vascular_resistance
Published on 1 May 2024