Kuckelt W, Dauberschmidt R, Bender V, Hieronymi U, Mrochen H, Winsel K, Meyer M
Exp Pathol. 1981;20(2):88-104.
Disturbed water balance at the alveolo-capillary membrane resulting in decreased pulmonary compliance is one of the functional characteristics in the Adult Respiratory Distress Syndrome (ARDS). In artificially ventilated LEWE Mini Pigs repeated pulmonary lavage was performed. The aim was to produce a state like ARDS by affecting the lung alveolar surfactant system which is included into the sum of factors which are responsible for the normal water balance of the alveolo-capillary membrane. This condition was supposed to be maximized if the lung compliance reached its lowest value after pulmonary lavage. Regarding this the pathophysiologic changes in this ARDS model were characterized by increased airway resistance and dead space ventilation as well as decreased arterial oxygenation. Severe ventilation perfusion abnormality was represented hemodynamically by the increased pulmonary vascular resistance and the decreased pulmonary non-shunt blood flow. The morphological (macroscopic, light-and electronmicroscopic) changes indicate strongly that in this type of ARDS model all functional compartments of the alveolocapillary membrane are severely affected. Decreased colloid osmotic pressure of blood plasma samples underlines the severity of changes in the water balance at the alveolo-capillary membrane in this type of lung injury.
肺泡 - 毛细血管膜处水平衡紊乱导致肺顺应性降低是成人呼吸窘迫综合征（ARDS）的功能特征之一。在人工通气的LEWE小型猪身上进行了反复肺灌洗。目的是通过影响肺泡表面活性物质系统来制造一种类似ARDS的状态，肺泡表面活性物质系统是负责肺泡 - 毛细血管膜正常水平衡的诸多因素之一。如果肺灌洗后肺顺应性达到最低值，这种状态就会达到最大化。就此而言，该ARDS模型的病理生理变化表现为气道阻力增加、死腔通气增加以及动脉氧合降低。严重的通气 - 灌注异常在血流动力学上表现为肺血管阻力增加和肺非分流血流量减少。形态学（宏观、光镜和电镜）变化强烈表明，在这种类型的ARDS模型中，肺泡 - 毛细血管膜的所有功能区都受到严重影响。血浆样本胶体渗透压降低突出了这种类型肺损伤中肺泡 - 毛细血管膜水平衡变化的严重程度。
