Drake R E, Anwar Z, Kee S, Gabel J C
Department of Anesthesiology, University of Texas Medical School, Houston 77030.
Am J Physiol. 1993 Sep;265(3 Pt 2):R703-5. doi: 10.1152/ajpregu.1993.265.3.R703.
Intravenous fluid infusions cause increased venous pressure and increased lymph flow throughout the body. Together the increased lymph flow and increased venous pressure (the outflow pressure to the lymphatic system) should increase the pressure within the postnodal intestinal lymphatics. To test this, we measured the pressure in postnodal intestinal lymphatics and the neck vein pressure in five awake sheep. At baseline, the neck vein pressure was 1.2 +/- 1.5 (SD) cmH2O and the lymphatic pressure was 12.5 +/- 1.7 cmH2O. When we infused Ringer solution intravenously (10% body weight in approximately 50 min), the neck vein pressure increased to 17.3 +/- 0.9 cmH2O and the lymphatic pressure increased to 24.6 +/- 3.8 cmH2O (both P < 0.05). In two additional sheep, the thoracic duct lymph flow rate increased from 0.8 +/- 0.4 ml/min at baseline to 5.5 +/- 2.0 ml/min during the infusions. Our results show that postnodal intestinal lymphatic pressure may increase substantially during intravenous fluid infusions. This is important because increases in postnodal lymphatic pressure may slow lymph flow from the intestine.
静脉输液会导致全身静脉压升高和淋巴液流量增加。淋巴液流量增加和静脉压升高(淋巴系统的流出压力)共同作用,应会使节后肠淋巴管内的压力升高。为了验证这一点,我们测量了5只清醒绵羊的节后肠淋巴管压力和颈静脉压力。在基线状态下,颈静脉压力为1.2±1.5(标准差)厘米水柱,淋巴管压力为12.5±1.7厘米水柱。当我们静脉输注林格溶液(约50分钟内输注体重的10%)时,颈静脉压力升至17.3±0.9厘米水柱,淋巴管压力升至24.6±3.8厘米水柱(两者P<0.05)。在另外两只绵羊中,胸导管淋巴液流速从基线时的0.8±0.4毫升/分钟增加到输注期间的5.5±2.0毫升/分钟。我们的结果表明,静脉输液期间节后肠淋巴管压力可能会大幅升高。这很重要,因为节后淋巴管压力升高可能会减缓肠道淋巴液的流动。