Mechanisms of Changes in Nitrogen Washout and Lung Volumes after Saline Infusion in Humans

This study was performed to determine the roles of increased intrathoracic blood volume and increased vagal tone in the changes in lung volume and nitrogen washout produced by saline infusion. In the first study, measurements of TLC, VC, FRC, ERV, and slope of phase III nitrogen washout (delta N2) were made on 8 subjects before, during, and after inflation of the leg compartments of medical anti-shock trousers (MAST). In the second study, 13 volunteers were infused intravenously with warm saline (30 ml/kg) for 30 min. Repeat measurements were made approximately 20 and 40 min after infusion. Each subject then received intravenously 0.03 mg/kg atropine, and measurements were repeated. In 7 of these subjects, a third study was performed in which the atropine was injected before saline infusion. Inflation of the MAST (see figures 5 and 6) caused a 1.9% decrease in VC, 5.3% decrease in FRC, and no change in delta N2. Saline infusion caused decreases in TLC, VC, and FRC (4.0, 3.1, and 10.1%, respectively) and a 15.0% increase in delta N2. Atropine reversed the change in delta N2 after saline infusion and prevented these changes when given prior to saline. Atropine had no effect on lung volumes whether given before or after saline infusion. We speculate from our data that saline infusion has 2 effects on the lung. One is a simple displacement of air by increased intravascular volume producing the reduction in lung volumes. The second is an increase in small airways resistance that is mediated by vagal reflex and blocked with atropine.