Lung fluid balance in awake newborn lambs with pulmonary edema from rapid intravenous infusion of isotonic saline.

To study pulmonary transvascular filtration of fluid and the normal adaptive response of newborn animals to excessive water in the lungs, we measured lung lymph flow, pulmonary vascular pressures, and the concentration of protein in lymph and plasma of nine unanesthetized 1- to 3-wk-old lambs, before, during, and after a rapid iv infusion of isotonic saline, 130-250 ml/kg.hr for 3-4 hr. During infusions, lung vascular pressures increased, the transvascular gradient of protein osmotic pressure decreased, and there was a 2- to 5-fold increase of lung lymph flow. When infusions stopped, lymph flow decreased, as the concentration of protein in plasma increased and pulmonary vascular pressures decreased to new steady-state levels. The concentration of protein in lymph did not change for several hours after the infusions. Body weight increased by 28% and extravascular lung water content was 19% above normal after saline; these changes were associated with mild tachypnea, hypercarbia, and hypoxemia. Sections of lung from these lambs had prominent cuffs of fluid surrounding large blood vessels.