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Semin Respir Crit Care Med 2023; 44(05): 538-554
DOI: 10.1055/s-0043-1770059
Review Article

The Pulmonary Vasculature

Susan R. Hopkins
1   Department of Radiology, University of California, San Diego, California
,
Michael K. Stickland
2   Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta
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Abstract

The pulmonary circulation is a low-pressure, low-resistance circuit whose primary function is to deliver deoxygenated blood to, and oxygenated blood from, the pulmonary capillary bed enabling gas exchange. The distribution of pulmonary blood flow is regulated by several factors including effects of vascular branching structure, large-scale forces related to gravity, and finer scale factors related to local control. Hypoxic pulmonary vasoconstriction is one such important regulatory mechanism. In the face of local hypoxia, vascular smooth muscle constriction of precapillary arterioles increases local resistance by up to 250%. This has the effect of diverting blood toward better oxygenated regions of the lung and optimizing ventilation–perfusion matching. However, in the face of global hypoxia, the net effect is an increase in pulmonary arterial pressure and vascular resistance. Pulmonary vascular resistance describes the flow-resistive properties of the pulmonary circulation and arises from both precapillary and postcapillary resistances. The pulmonary circulation is also distensible in response to an increase in transmural pressure and this distention, in addition to recruitment, moderates pulmonary arterial pressure and vascular resistance. This article reviews the physiology of the pulmonary vasculature and briefly discusses how this physiology is altered by common circumstances.

Keywords

gravity - Zone model - fractal - hypoxic pulmonary vasoconstriction - pulmonary vascular resistance


Publikationsverlauf

Artikel online veröffentlicht:
10. Oktober 2023

© 2023. Thieme. All rights reserved.

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333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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