Michael A. Gropper

University of California, San Francisco

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Angela K. M. Lipshutz

National Institutes of Health Clinical Center

Jeanine P. Wiener-Kronish

Massachusetts General Hospital

Michael A. Matthay

University of California, San Francisco

Elise Paradis

University of Toronto

Myles Leslie

University of Calgary

Scott Reeves

Kingston University

Simon Kitto

University of Ottawa

Mark R. Looney

University of California, San Francisco

Janet Aldrich

University of California, San Francisco

Pearl Toy

University of California, San Francisco

Cooperative Institutions

University of California, San Francisco

225

Harvard University

123

Massachusetts General Hospital

Johns Hopkins University

University of California San Francisco Medical Center

University of California, Los Angeles

Brigham and Women's Hospital

University of Pennsylvania

Stanford University

University of Colorado Denver

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Lung microvascular pressure profile measured by micropuncture in anesthetized dogs

Journal of Applied Physiology (1988)

John M. Shepard Michael A. Gropper Gunnar Nicolaysen Norman C. Staub Jahar Bhattacharya

We have micropunctured the lung in the open thorax of 17 anesthetized dogs to measure microvascular pressure. After intravenous pentobarbital sodium (25 mg/kg), we exposed the left lung through a wide left thoracotomy, which required rib excision. Through a double-lumen endotracheal tube, we ventilated the right lung to maintain normal blood gases and pH while we held the left lung motionless at an inflation pressure of 5 cmH2O. To reduce motion on the surface of the left lower lobe, we resected the left upper lobe, placed a Plexiglas baffle between the lobe and the heart, and held the lobe surface in a suction ring. In accordance with procedures we have previously described, we micropunctured subpleural vessels to measure microvascular pressure. At base line when alveolar pressure exceeded left atrial pressure (zone 2 conditions), 21, 38, and 41% of the total pressure drop occurred, respectively, in the arterial, microvascular, and venous segments. When we raised left atrial pressure above alveolar pressure (zone 3 conditions), the corresponding pressure drops were 30, 55, and 20% of total. The blood flow in the superficial layer of the lung averaged 15% less than the flow in the deeper layers as measured by distribution of 99mTc-albumin macroaggregates. We conclude that the intact and the isolated lung preparations in dog exhibit similar distributions of subpleural microvascular pressure.

Pulmonary gas pressures

Thoracotomy

Lumen (anatomy)

10.1152/jappl.1988.64.2.874

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Citations (19)

Intensive Care Unit–acquired Muscle Weakness

Anesthesiology (2015)

Angela K. M. Lipshutz Michael A. Gropper

Muscle weakness

10.1097/aln.0000000000000875

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Citations (7)

Trends in personal protective equipment use by clinicians performing airway procedures for patients with coronavirus disease 2019 in the USA from the intubateCOVID registry

British Journal of Anaesthesia (2021)

Timothy G. Gaulton Mark D. Neuman Timothy G. Gaulton Mark D. Neuman Meghan B. Lane‐Fall

Personal Protective Equipment

Coronavirus

2019-20 coronavirus outbreak

Pandemic

10.1016/j.bja.2021.01.019

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Citations (1)

Prediction is very difficult, especially about the future—Niels Bohr*

Critical Care Medicine (2011)

Anne L. Donovan Michael A. Gropper

Department of Anesthesia and Perioperative Care, University of California San Francisco, Critical Care Medicine, San Francisco, CA The authors have not disclosed any potential conflicts of interest.

10.1097/ccm.0b013e31821e85dc

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Citations (2)

A LASSO-DERIVED PREDICTIVE MODEL FOR POSTOPERATIVE RESPIRATORY FAILURE IN A HETEROGENEOUS ADULT ELECTIVE SURGERY PATIENT POPULATION

CHEST Journal (2023)

Jacqueline C. Stocking Sandra L. Taylor SILI FAN Theodora Wingert Christiana Drake

Lasso

10.1016/j.chest.2023.07.1061

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Citations (0)

Intraluminal Water Increases Expression of Plasmid DNA in Rat Lung

Human Gene Therapy (1996)

Teiji Sawa Hiroshi Miyazaki Jean‐François Pittet J. H. Widdicombe Michael A. Gropper

Effective gene delivery to specific organs is a major goal for human gene therapy. The lung's structure allows instillation of agents into the airspaces, directly adjacent to the lung epithelium. We hypothesized that the air-space instillation of hypotonic solutions would increase the permeability of the lung epithelium and increase DNA uptake. This hypothesis was tested by instilling plasmid DNA (p4241) encoding the luciferase gene in isotonic and hypotonic solutions. The highest luciferase expression in the lung was achieved after the instillation of this plasmid DNA in distilled water. Aerosolization of water just before the instillation of the plasmid DNA also enhanced the expression level of luciferase in the lung. In addition, an intralobar instillation of the plasmid DNA in water significantly increased the luciferase expression, suggesting that the instillation of the plasmid over a smaller surface area increased expression. Levels of expression could be measured for 3 days. Water increases the permeability of lung epithelial cells transiently and/or enhances gene expression and can be used to achieve gene expression in the lung airspaces for short intervals without toxicity. In vitro studies have found that water transiently increases the apical and basal permeability of human tracheal cells (Widdicombe, et al., 1996). Therefore, water was utilized in vivo to increase the lung epithelial permeability and, thereby, to increase the internalization of plasmids encoding the luciferase gene. Used as the vehicle for the plasmid, or as an aerosol pretreatment to increase the permeability of a greater fraction of the epithelial cells in the lung, water was found to increase luciferase gene expression in the lung, when compared to a variety of other vehicles that included various buffered salt solutions and an adenoviral complex.

10.1089/hum.1996.7.8-933

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Citations (26)

A Clinical Trial to Detect Subclinical Transfusion-induced Lung Injury during Surgery

Anesthesiology (2015)

John Feiner Michael A. Gropper Pearl Toy Jeremy A. Lieberman Jenifer Twiford

Abstract Background: Transfusion-related acute lung injury incidence remains the leading cause of posttransfusion mortality. The etiology may be related to leukocyte antibodies or biologically active compounds in transfused plasma, injuring susceptible recipient’s lungs. The authors have hypothesized that transfusion could have less severe effects that are not always appreciated clinically and have shown subtly decreased pulmonary oxygen gas transfer in healthy volunteers after transfusion of fresh and 21-day stored erythrocytes. In this study, the authors tested the same hypothesis in surgical patients. Methods: Ninety-one patients undergoing elective major spine surgery with anticipated need for erythrocyte transfusion were randomly allocated to receive their first transfusion of erythrocytes as cell salvage (CS), washed stored, or unwashed stored. Clinicians were not blinded to group assignment. Pulmonary gas transfer and mechanics were measured 5 min before and 30 min after erythrocyte transfusion. Results: The primary outcome variable, gas transfer, as assessed by change of Pao2/Fio2, with erythrocyte transfusion was not significant in any group (mean ± SD; CS: 9 ± 59; washed: 10 ± 26; and unwashed: 15 ± 1) and did not differ among groups (P = 0.92). Pulmonary dead space (VD/VT) decreased with CS transfusion (−0.01 ± 0.04; P = 0.034) but did not change with other erythrocytes; the change from before to after erythrocyte transfusion did not differ among groups (−0.01 to +0.01; P = 0.28). Conclusions: The authors did not find impaired gas exchange as assessed by Pao2/Fio2 with transfused erythrocytes that did or did not contain nonautologous plasma. This clinical trial did not support the hypothesis of erythrocyte transfusion-induced gas exchange deficit that had been found in healthy volunteers.

Subclinical infection

Etiology

Elective surgery

Transfusion Therapy

Fresh frozen plasma

10.1097/aln.0000000000000689

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Citations (9)

Interprofessional care in intensive care settings and the factors that impact it: Results from a scoping review of ethnographic studies

Journal of Critical Care (2013)

Elise Paradis Myles Leslie Michael A. Gropper Hanan Aboumatar Simon Kitto

10.1016/j.jcrc.2013.05.015

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Citations (23)

Immunolocalization of the mercurial-insensitive water channel and glycerol intrinsic protein in epithelial cell plasma membranes.

Proceedings of the National Academy of Sciences (1995)

Antonio Frigeri Michael A. Gropper Christopher W. Turck A.S. Verkman

Two water channel homologs were cloned recently from rat kidney, mercurial-insensitive water channel (MIWC) and glycerol intrinsic protein (GLIP). Polyclonal antibodies were raised against synthetic C-terminal peptides and purified by affinity chromatography. MIWC and GLIP antibodies recognized proteins in rat kidney with an apparent molecular mass of 30 and 27 kDa, respectively, and did not cross-react. By immunofluorescence, MIWC and GLIP were expressed together on the basolateral plasma membrane of collecting duct principal cells in kidney. By immunohistochemistry, MIWC and GLIP were expressed on tracheal epithelial cells with greater expression of GLIP on the basal plasma membrane and MIWC on the lateral membrane; only MIWC was expressed in bronchial epithelia. In eye, GLIP was expressed in conjunctival epithelium, whereas MIWC was found in iris, ciliary body, and neural cell layers in retina. MIWC and GLIP colocalized on the basolateral membrane of villus epithelial cells in colon and brain ependymal cells. Expression of MIWC and GLIP was not detected in small intestine, liver, spleen, endothelia, and cells that express water channels CHIP28 or WCH-CD. These studies suggest water/solute transporting roles for MIWC and GLIP in the urinary concentrating mechanism, cerebrospinal fluid absorption, ocular fluid balance, fecal dehydration, and airway humidification. The unexpected membrane colocalization of MIWC and GLIP in several tissues suggests an interaction at the molecular and/or functional levels.

Epithelial polarity

Apical membrane

Polyclonal antibodies

Immunofluorescence

10.1073/pnas.92.10.4328

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Citations (396)

Say NO to Old Blood*

Critical Care Medicine (2013)

Brian M. Gilliss Michael A. Gropper

Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA * See also p. 2492. The authors have disclosed that they do not have any potential conflicts of interest.

10.1097/ccm.0b013e318291cb05

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Citations (0)