Effect of outflow pressure on intestinal lymph flow in unanesthetized sheep.

Lymphatic vessels are important in removing excess fluid from the intestines and preventing intestinal edema. In this study we used the relationship between intestinal lymph flow rate (QL) and lymphatic outflow pressure (PO) to analyze the flow from intestinal lymphatics in unanesthetized sheep. We cannulated intestinal lymphatic vessels in six anesthetized sheep. One to 3 days after the surgery, we measured QL as we increased PO in steps. We found no QL decrease until PO greater than 15 cmH2O, but QL decreased significantly for PO greater than 15 cmH2O and was decreased to zero at PO = 34 +/- 13 (SD) cmH2O. In three experiments, we used the pressure pulses generated by the active lymphatic pump to estimate the pump stroke volume and frequency. These data indicate that increases in lymphatic pumping prevented a QL decreased for PO less than 15 cmH2O and the QL decrease for PO greater than 15 cmH2O was associated with lymphatic pump failure. When we increased portal venous pressure from baseline (10.1 +/- 4.1 cmH2O) to 24.3 +/- 6.2 cmH2O, lymph flow increased, but it was much more sensitive to outflow pressure. These results are important because they indicate that the ability of the lymphatics to remove fluid from edematous intestines may be compromised by small increases in lymphatic outflow pressure.