Liquid movements in ventilated and perfused isolated lungs of fetal sheep at 0.87, 0.90, and 0.95 of term.

To study lung liquid movements, an isolated lung model, adapted from adult physiology, was developed to measure pulmonary weight changes after the onset of artificial ventilation of lungs from 16 fetal sheep at 0.87 (n = 5), 0.90 (n = 6), and 0.95 (n = 5) of gestation. The fetuses were delivered by Caesarean section. After tracheotomy and thoracotomy under general anaesthesia, a blocked air-free tracheal cannula and a pulmonary arterial catheter were inserted and secured to ensure in situ perfusion of the pulmonary circulation (Krebs-Henseleit buffer) without ventilation before the lungs were removed from the chest and mounted in a specially designed apparatus. Lung weight and pulmonary perfusion pressure were recorded continuously before, during and after the onset of ventilation. After 50 min of ventilation the perfusate was allowed to recirculate and samples were taken at 10-min intervals to determine the concentrations of sodium and the activity of lactate dehydrogenase (LDH) as a marker for cell destruction. In all lungs studied there was a significant removal of lung liquid after the onset of ventilation as assessed by lung weight loss. However, there was a positive correlation between lung weight loss and gestational age of the donor fetuses. These changes were accompanied by a rise in sodium concentrations in the perfusate, possibly suggesting that active sodium transport across the pulmonary epithelium facilitates alveolar liquid removal. As the experiments progressed the lungs regained weight while LDH concentrations increased, indicating that lung cell destruction causing pulmonary oedema may be involved. This pulmonary weight gain was inversely related to gestational age. It is concluded that in isolated ventilated and perfused lungs from fetal sheep, lung liquid removal is an age-related phenomenon that might involve an active sodium transport mechanism. It is further concluded that the development of pulmonary oedema during ventilation is also age related.