Abstract
The effect of pneumonectomy and mediastinal lymphatic interruption on gravimetrically measured extravascular lung water was studied in dogs. Raising left atrial pressure to 23 mm Hg caused a significant increase in extravascular lung water in normal dogs compared to controls. The same hemodynamic challenge, however, when applied to pneumonectomized dogs caused a significantly greater increase in extravascular lung water than in the hemodynamically challenged normal dogs. When a moderate mediastinal lymphatic interruption was added to the pneumonectomy, there was no additional increase in extravascular lung water. We suggest that the remaining lungs after contralateral pneumonectomy are more prone to extravascular fluid development when subjected to a significant hemodynamic challenge because of the combination of an increase in transmembrane fluid transudation into the interstitium of the remaining lung and loss of parenchymal/hilar lymphatic drainage routes. In this situation, lymphatic clearance thresholds are more easily exceeded, extravascular fluid accumulates and pulmonary edema is the result.
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Little, A.G., Langmuir, V.K., Singer, A.H. et al. Hemodynamic pulmonary edema in dog lungs after contralateral pneumonectomy and mediastinal lymphatic interruption. Lung 162, 139–145 (1984). https://doi.org/10.1007/BF02715641
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DOI: https://doi.org/10.1007/BF02715641