Abstract
An increase in extravascular lung water (EVLW) is indicative of pulmonary edema and the measurement of EVLW has been considered as an important clue for the early detection of pulmonary edema, which is a serious complication of lung surgery. The influence of thoractomy, manual lung manipulation and rapid fluid transfusion on EVLW were experimentally studied in the lung tissue of dogs, using the double indicator dilution method and comparing it with the drying method. The following results were obtained. 1) EVLW measured by the double indicator dilution method correlated well with EVLW measured by the drying method of tissue at 80°C for 48 hours. 2) EVLW was significantly increased immediately after rapid fluid transfusion. EVLW increased as the osmotic pressure in the transfused fluid became higher. 3) Even the simple procedure of thoracotomy resulted in an increase of EVLW and the addition of manual compression to the lung facilitated this increase of EVLW even further.
Similar content being viewed by others
References
Visscher MB, Haddy FJ, Stephens G. The physiology and pharmacology of lung edema. Pharmacol Rev 1956; 8: 389.
Chinard FP, Enns T. Transcapillary pulmonary exchange of water in the dog. Am J Physiol 1954; 178: 197–202.
Lewis Fr, Elings VL. Microprocessor determination of lung water using thermal-green dye double indicator dilution. Surg Forum 1979; 29: 182–184.
Sagawa Y. Double indicator-dilution method (I). Resp and Circ 1978; 26: 238. (in Japanese)
Staub NC. Pulmonary edema. Physiol Rev 1974; 54: 740–742.
Sagawa Y. Double indicator-dilution method (II). Resp and Circ 1978; 26: 320. (in Japanese)
Noble WH, Obdrzalek J, Kay JC. A new technique for measuring pulmonary edema. J Apple Physiol 1973; 34: 508–512.
Pearce ML, Beazell JW. The measurement of pulmonary parenchymal volume by thermal indicator dilution (Abstract). Clin Res 1966; 14: 182.
Ishibe Y. Double indicator dilution method using heat and dye for measurement of pulmonary edemain vivo. Anesthesiology 1978; 27: 835–842. (in Japanese)
Iwami Y. Experimental studies on the influence of thoracotomized invasion on pulmonary extravascular water volume—Quantitative determination by means of the double indicator dilution method.— JJATS 1982; 30: 1273–1284. (in Japanese)
Mihm FG, Feeley TW, Rosenthal MH. Measurement of extravascular lung water in dogs using thermal-green dye indicator dilution method. Anesthesiology 1982; 57: 116–122.
Pearce MI, Yamashita J, Beazell J. Measurement of pulmonary edema. Circulation Res 1965; 16: 482–488.
Noble WH, Kay JC, Maret KH, Caskanette G. Reappraisal of extravascular lung thermal volume as a measure of pulmonary edema. Appl Physiol 1980; 48: 120–129.
Nakanishi Y, Nakajo N, Tomomatsu E, Takaori M. Influence of massive infusion of electrolyte solution on pulmonary water content and respiratory function. Anesthesiology 1975; 24: 258–265. (in Japanese)
Brigham KL, Woolverton WC, Blake LH, Staub NC. Increased sheep lung vascular permeability caused by pseudomonas bacteremia. J Clin Invest 1974; 54: 792–804.
Virgilio RW, Rice CL, Smith DE, James DR, Zarins CK, Hobelmann CF, Peters RM. Crystalloidvs colloid resuscitation: Is one better? A randomized clinical study. Surgery 1978; 85: 129–139.
Stein L, Beraud JJ, Morissete M, Lug PD, Weil MH, Shubin H. Pulmonary edema during volume infusion. Circulation 1975; 52: 483–489.
Harms BA, Kramer GC, Bodai BI, Demling RH. Effect of hypoproteinemia on pulmonary and soft tissue edema formation. Crit Care Med 1981; 9: 503–508.
O’Connor PC, Erskine JG, Pringle TH. Pulmonary oedema after transfusion with fresh frozen plasma. Brit Med J 1981; 282: 379–380.
Lowe RJ, Moss GS, Jilek J, Levine HD. Crystalloidvs colloid in the etiology of pulmonary failure after trauma: A randomized trial in man. Surgery 1977; 81: 676–683.
Kanamaru H. Extravascular lung water content following thoracic vagotomy. Experimental investigations in relation to the cause of pulmonary complications after surgery for esophageal cancer. J Jpn Surg Soc 1984; 85: 119–131.
Tsubokawa T. Pathogenic mechanism of neurogenic lung edema. The Jap Journal of Acute Medicine 1983; 8: 947–953.
Yoneyama T. Physiological disorders during and after the thoracotomy. Resp and Circ 1981; 29: 1035–1042. (in Japanese)
Ishida H, Mukubou A. Anesthesia and cardiopulmonary hemodynamics. Surg Therapy 1971; 25: 35–45. (in Japanese)
Howell JBL, Permutt S, Proctor DF, Riley RL. Effect of inflation of the lung on different parts of pulmonary vascular bed. J Appl Physiol 1961; 16: 71–76.
Harasawa M, Rodbard S. Ventilatory air pressure and pulmonary vascular resistance. Am Heart J 1960; 60: 73–79.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Chiyotanda, S. Extravascular lung water with special reference to thoracotomy, manual lung manipulation and rapid fluid transfusion. The Japanese Journal of Surgery 18, 376–383 (1988). https://doi.org/10.1007/BF02471460
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF02471460