Klaesner J W, Roselli R J, Evans S, Pou N A, Parker R E, Tack G, Parham M
Department of Biomedical Engineering, Vanderbilt University, School of Engineering, Nashville, TN 37235.
Ann Biomed Eng. 1994 Nov-Dec;22(6):660-73. doi: 10.1007/BF02368291.
Lung fluid balance, which is governed by the product of net transvascular pressure difference and lung filtration coefficient, can be altered in pulmonary diseases. A simple measurement of the lung filtration coefficient (Kfc) would be clinically useful and has been examined by several researchers. Current methods of determining Kfc include gravimetric measurement in isolated lungs and lymph node cannulation, neither of which can be extended to human use. Optical measurements of protein concentration changes in venous blood can be combined with pressure measurements to calculate Kfc. Blood, though, contains red corpuscles, which tend to absorb and scatter light, obscuring these optical measurements. In this study, an optical system was developed in which a polysulfone filter cartridge was used to remove red blood cells before the filtrate was passed through a spectrophotometer. Absorbance changes caused by changes in concentration of albumin labeled with Evans Blue were monitored at 620 nm after venous pressure was elevated by about 13 cm H2O. Optical measurements of Kfc averaged 0.401 +/- 0.074 (ml/min cm H2O 100 g DLW) for an isolated canine lung. Optical measurements of Kfc (0.363 +/- 0.120 ml/min cm H2O 100 g DLW) were made for the first time in an intact, closed chest sheep in which pulmonary pressure was altered by inflating a Foley balloon in the left atrium. We conclude that absorbance and scattering artifacts introduced by red blood cells can be eliminated by first filtering the blood through polysulfone fibers. Kfc measurements using the optical method are similar to values obtained by others using gravimetric methods. Finally, we have demonstrated that the technique can be used to estimate Kfc in an intact animal.
肺液体平衡受跨血管净压力差与肺滤过系数乘积的支配,在肺部疾病中可能会发生改变。简单测量肺滤过系数(Kfc)在临床上会很有用,已有多位研究人员对此进行了研究。目前测定Kfc的方法包括在离体肺中进行重量测量和淋巴结插管,这两种方法都无法应用于人体。静脉血中蛋白质浓度变化的光学测量可与压力测量相结合来计算Kfc。然而,血液中含有红细胞,红细胞会吸收和散射光线,从而干扰这些光学测量。在本研究中,开发了一种光学系统,其中使用聚砜滤筒在滤液通过分光光度计之前去除红细胞。在静脉压力升高约13 cm H2O后,于620 nm处监测由伊文思蓝标记的白蛋白浓度变化引起的吸光度变化。对于离体犬肺,Kfc的光学测量平均值为0.401±0.074(ml/min·cm H2O·100 g DLW)。首次在完整的闭胸绵羊中进行了Kfc的光学测量(0.363±0.120 ml/min·cm H2O·100 g DLW),通过在左心房中充盈弗利氏球囊来改变肺压力。我们得出结论,通过首先使血液通过聚砜纤维过滤,可以消除红细胞引入的吸光度和散射伪像。使用光学方法进行的Kfc测量与其他人使用重量法获得的值相似。最后,我们证明了该技术可用于估计完整动物体内的Kfc。