A comparative study of the effects of dry vs. humidified ventilation on canine lungs.

To compare the effects on canine ciliary and bronchial mucosal function of varying periods of ventilation with dry vs. humidified gas mixtures, 29 anesthetized dogs underwent 2, 4, and 6 hours of ventilation through a Carlen's double-lumen tube. Six dogs were evaluated by clearance studies, nine by differential bronchospirometry, six by surfactant studies, six by electron microscopy, and two by ventilation scanning. By means of two separate respiratory systems, dry gas (DG) was used to ventilate the right lung, and humidified gas (HG) ventilated the left lung in each dog. Serial chest roentgenograms showed more rapid clearance of inspired tantalum dust from the HG-ventilated lung in each of the six dogs, the disparity in clearance between the two lungs being more pronounced after longer periods of ventilation. The surface tension in DG-ventilated lungs increased fourfold, whereas in HG-ventilated lungs it increased only twofold as compared to preoperative values. Longer periods of ventilation did not change the surface tension appreciably in either DG- or HG-ventilated lungs. Scanning electron micrographs of bronchial mucosa from DG-ventilated lungs showed tangling and matting of cilia with a granular and stringy material attached to most cilia; these changes were much less pronounced in HG-ventilated lungs. Bronchospirometric studies showed an increase in ventilatory function in each of the lungs ventilated with the HG mixture (percent Vo2 on 100 percent oxygen increased 27.7 percent) to compensate for the decreased gas exchange provided by the contralateral DG-ventilated lung. Function in each of the lungs returned to normal within 24 hours. Ventilation scans with Xenon133 showed no apparent change in isotope uptake in the HG-ventilated lungs as compared to the DG lungs during the first 24 hours after ventilation. The observations from the present study suggest that ventilation of canine lungs with DG for 4 or more hours dries mucus and transiently retards mucociliary clearance and gas exchange. These changes may be minimized by ventilation with a humidified gas mixture. Application of these findings to patients undergoing prolonged general anesthesia and to lung preservation studies is suggested.