Interstitial fluid and transcapillary fluid balance in the lung.

Alterations in extravascular lung water content when capillary pressure or plasma colloid osmotic pressure is increased have been evaluated in isolated, continuously weighed, plasma-perfused pairs of rabbit lungs. After modest increases in left atrial pressure, most preparations rapidly reached a new stable weight, and thus a new transcapillary fluid balance, but no significant increase in extravascular lung water content could be detected. In preparations where there was still a steady, slow gain in weight and thus still some transvascular filtration of fluid 15 min after the increase in pressure, a moderate but significant increase in extravascular water could be detected. It is concluded that only very small transvascular shifts of fluid occur in the lungs when capillary pressure changes, as long as this change is kept below the level that causes oedema. This limitation of pressure-induced transvascular shifts of fluid in the lung could be explained by the existence, close to the capillaries, of a small interstitial space containing fluid with a high protein concentration. Alterations in the colloid osmotic pressure exerted by this fluid would then contribute markedly towards continuous readjustment of the transcapillary fluid balance in the lung. Experiments by other workers indicate that alveolar pressure can markedly affect the transcapillary fluid balance of the isolated perfused lung.