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液体容量负荷对犬肺间质白蛋白清除及淋巴液流动的影响。

The effect of fluid volume loading on exclusion of interstitial albumin and lymph flow in the dog lung.

作者信息

Parker J C, Falgout H J, Parker R E, Granger D N, Taylor A E

出版信息

Circ Res. 1979 Oct;45(4):440-50. doi: 10.1161/01.res.45.4.440.

DOI:10.1161/01.res.45.4.440
PMID:476867
Abstract

The excluded volume fraction for interstitial albumin (FE) was estimated in the lungs of seven mongrel dogs during steady state conditions following intravenous infusions of Ringer's solution, amounting to 0, 5, 10, and 15% of body weight (BW). We estimated the tissue blood volume with 51Cr red cells, extracellular space with 99mTc-diethylenetriaminepentaacetic acid (99mTc-DTPA), and the albumin pool with 125I human serum albumin. A prenodal tracheobronchial lymphatic was cannulated for recording lymph flow (QL), total protein (CL), and albumin [CL(A)] concentrations. From these measurements, we calculated the extravascular albumin content (QA) and 99mTc-DTPA space (VI) of lung tissue samples collected at the successive volume expansions. The apparent tissue concentration of albumin (CApp = QA/VI) decreased from a control value (mean +/- SE) of 0.89 +/- 0.06 to 0.46 +/- 0.04 g/dl following the 15% BW infusion, whereas CL(A) decreased from 1.43 +/- 0.16 to 0.50 +/- 0.07 g/dl for the same volume expansion. By assuming that pulmonary lymph represented tissue fluid, we calculated a control FE of 0.38 +/- 0.02 using the equation, FE = 1 - [CApp/CL(A)]. FE decreased following successive infusions to 0.28 +/- 0.03, 0.16 +/- 0.02, and 0.10 +/- 0.02. These data indicate a significant contribution by the decrease in FE to the total decrease in tissue albumin concentration as interstitial fluid volume increased. Somewhat unexpectedly, the mean steady state QL increased by only 2.1-fold following the 5% BW expansion, but did not further increase following subsequent volume expansions. This has been attributed to a nonlinear interstitial compliance, sequestration of interstitial fluid, or possible deterioration of the experimental preparation.

摘要

在向7只杂种犬静脉输注林格氏液(剂量分别为体重的0%、5%、10%和15%)后的稳态条件下,估计了肺间质白蛋白的排除体积分数(FE)。我们用51Cr红细胞估计组织血容量,用99m锝-二乙三胺五乙酸(99mTc-DTPA)估计细胞外间隙,用125I人血清白蛋白估计白蛋白池。对一条节前气管支气管淋巴管进行插管,以记录淋巴流量(QL)、总蛋白(CL)和白蛋白[CL(A)]浓度。根据这些测量结果,我们计算了在连续扩容时采集的肺组织样本的血管外白蛋白含量(QA)和99mTc-DTPA间隙(VI)。白蛋白的表观组织浓度(CApp = QA/VI)在输注15%体重的液体后从对照值(均值±标准误)0.89±0.06降至0.46±0.04 g/dl,而在相同扩容情况下,CL(A)从1.43±0.16降至0.50±0.07 g/dl。通过假设肺淋巴代表组织液,我们使用公式FE = 1 - [CApp/CL(A)]计算出对照FE为0.38±0.02。连续输注后,FE降至0.28±0.03、0.16±0.02和0.10±0.02。这些数据表明,随着间质液体积增加,FE的降低对组织白蛋白浓度的总体降低有显著贡献。有点出乎意料的是,在输注5%体重的液体后,平均稳态QL仅增加了2.1倍,但在随后的扩容后并未进一步增加。这被归因于间质顺应性的非线性、间质液的隔离或实验准备可能的恶化。

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