Newly Published
Correspondence  |   January 2020
Physiologic Effects of Pulmonary Artery Occlusion: Reply
Author Notes
  • University of Milan-Bicocca, Monza, Italy; and Niguarda Ca’ Granda, Milan, Italy (T.L.). Thomas.Langer@unimib.it
  • Accepted for publication December 17, 2019.
    Accepted for publication December 17, 2019.×
Article Information
Correspondence
Correspondence   |   January 2020
Physiologic Effects of Pulmonary Artery Occlusion: Reply
Anesthesiology Newly Published on January 24, 2020. doi:https://doi.org/10.1097/ALN.0000000000003139
Anesthesiology Newly Published on January 24, 2020. doi:https://doi.org/10.1097/ALN.0000000000003139
We thank Dr. Roth for the interest in our experimental study, in which we described the changes in blood flow and ventilation secondary to a controlled regional pulmonary vascular occlusion.1  These physiologic compensations likely occur through an increase in airway resistance (bronchoconstriction) in the nonperfused lung areas. As a result, ventilation of nonperfused alveoli is reduced, limiting the increase in dead space fraction and preserving the ventilation-perfusion matching. Bronchoconstriction, and therefore wheezing, are thus possible symptoms of pulmonary embolism2,3  and might (rarely) be so pronounced to be mistaken for severe asthma.4 
Given these premises, Dr. Roth asks if bronchoconstriction (wheezing) secondary to pulmonary embolism should be treated, as an effective resolution of bronchoconstriction could cause an increase in dead space fraction, thus increasing the required minute ventilation to exhale the produced carbon dioxide load. Again, we thank him for the very interesting and clinically relevant question.