Effect of bronchial blood flow on pulmonary artery wedge pressure with pulmonary embolism

Discrepancies between pulmonary artery wedge pressure (WP) and left atrial pressure (LAP) occur with pulmonary embolism. Theoretically, this discrepancy could be affected by the bronchial circulation or by the type of embolus. To test this in dogs, we determined the effects of embolism induced by glass beads and by air upon the WP with intact vs. ligated bronchial blood flow to the left lower lobe. For those animals receiving pulmonary air infusions, the pulmonary artery pressure, WP, and pulmonary vascular resistance showed significant (p less than .05) elevations with no change in LAP. There were no changes in these values when the bronchial blood flow was interrupted. When glass beads (120 mu) were injected into the left lower lobe, the pulmonary artery pressure and pulmonary vascular resistance rose as in the air emboli groups (p less than .05); however, WP remained at control values and approximated LAP. Obstructing the bronchial blood flow did not change this response. We conclude that the discrepancy between WP and LAP depends upon the type of embolus and is not affected by bronchial blood flow.