Smith L, Andreasson S, Saldéen T, Risberg B
Department of Surgery I, Göteborg University, Sweden.
Lymphology. 1988 Sep;21(3):169-77.
A thoracic duct lymph fistula in combination with a lung lymph fistula in the awake sheep was used to evaluate effects of thoracic lymph diversion during a septic insult and to monitor systemic and local changes in the lung and gastrointestinal tract. Live Escherichia coli 10(9) kg-1 b.w. were infused in 9 sheep. After sepsis, arterial pressure, cardiac output, partial pressure of oxygen, leukocytes and platelets decreased significantly compared to baseline values. Pulmonary arterial pressure increased significantly throughout the experiment with peak values at 44 +/- 4 mmHg after 15 minutes. Lung lymph flow (QL) (n = 6) increased from 23 +/- 0.5 to 11.2 +/- 2.4 ml/30 minutes after 60 minutes. QL then decreased but remained elevated. Lymph to plasma protein concentration ratio (L/P) in lung lymph decreased from 0.62 +/- 0.02 during baseline to 0.47 +/- 0.04 after 60 minutes. L/P then increased and was, after 150 minutes, no longer different from baseline. These lung lymph data favor increased pulmonary microvascular permeability during sepsis. Lymph flow in the thoracic duct (QT) (n = 9) increased from 34.2 +/- 6 to 58.3 +/- 9 ml/30 minutes during the first 30 minutes after bacterial infusion. QT was, after 90 minutes, back to baseline but then progressively increased. L/P in thoracic lymph steadily increased from 0.56 +/- 0.03 to 0.78 +/- 0.04. Thromboxane B2 and 6-keto PGF1 alpha in thoracic duct and lung lymph increased significantly after bacterial infusion and remained elevated thereafter. Combined monitoring of thoracic duct and lung lymph enabled comparison of systemic and pulmonary reactions in septic sheep.
在清醒绵羊身上建立胸导管淋巴瘘合并肺淋巴瘘，用于评估脓毒症发作期间胸导管淋巴引流的效果，并监测肺和胃肠道的全身及局部变化。向9只绵羊静脉注射10(9)kg-1体重的活大肠杆菌。脓毒症发作后，与基线值相比，动脉压、心输出量、氧分压、白细胞和血小板均显著降低。在整个实验过程中，肺动脉压显著升高，15分钟后达到峰值44±4mmHg。肺淋巴流量（QL）（n = 6）在60分钟后从23±0.5增加到11.2±2.4ml/30分钟。QL随后下降，但仍高于基线水平。肺淋巴中淋巴与血浆蛋白浓度比（L/P）从基线时的0.62±0.02降至60分钟后的0.47±0.04。L/P随后升高，150分钟后与基线无差异。这些肺淋巴数据表明脓毒症发作期间肺微血管通透性增加。胸导管淋巴流量（QT）（n = 9）在细菌注入后的前30分钟内从34.2±6增加到58.3±9ml/30分钟。90分钟后QT恢复到基线水平，但随后逐渐升高。胸导管淋巴中的L/P从0.56±0.03稳步增加到0.78±0.04。细菌注入后，胸导管和肺淋巴中的血栓素B2和6-酮-前列腺素F1α显著升高，并持续升高。联合监测胸导管和肺淋巴有助于比较脓毒症绵羊的全身和肺部反应。
