Snashall P D, Weidner W J, Staub N C
J Appl Physiol Respir Environ Exerc Physiol. 1977 Apr;42(4):624-9. doi: 10.1152/jappl.1977.42.4.624.
We have compared extravascular lung water after extracellular fluid volume expansion with that predicted from lung sucrose space measured in control dogs. In control lungs mean extravascular water:dry weight ratio was 3.81 +/- 0.16 (SD) (n = 5) and extravascular sucrose space/dry weight was 1.79 +/- 0.45 (n = 4). After acute expansion of extracellular fluid volume by 10% of body weight mean extravascular water:dry lung weight was 4.17 +/- 0.27 (m = 5), less than half the predicted increase to 4.63 +/- 0.19, suggesting some degree of protection. After 20% (n = 4), 30% (n = 2), and 40% (n = 1) expansion, no protection was demonstrated and there was considerable scatter of lung water at each infusion volume. When volume expansion increased pulmonary capillary intravascular forces (due to decreased protein osmotic pressure and increased hydrostatic pressure) by more than 20 cmH2O there was a linear increase in extravascular lung water with increasing intravascular forces. Three dogs did not conform to this relationship and had disproportionately large increases in lung water, possibly due to alveolar flooding.
我们比较了细胞外液量扩张后血管外肺水与根据对照犬肺蔗糖间隙测得值预测的血管外肺水。在对照肺中,平均血管外水与干重之比为3.81±0.16(标准差)(n = 5),血管外蔗糖间隙与干重之比为1.79±0.45(n = 4)。细胞外液量急性扩张相当于体重的10%后,平均血管外水与干肺重之比为4.17±0.27(m = 5),低于预测增加至4.63±0.19的一半,提示存在一定程度的保护作用。在扩张20%(n = 4)、30%(n = 2)和40%(n = 1)后,未显示出保护作用,且在每个输注量时肺水有相当大的离散度。当容量扩张使肺毛细血管血管内压力(由于血浆蛋白渗透压降低和静水压升高)增加超过20 cmH₂O时,血管外肺水随血管内压力增加呈线性增加。三只犬不符合这种关系,肺水增加不成比例地大,可能是由于肺泡灌洗。