PERIPHERAL LYMPH-FLOW IN SHEEP WITH BACTERIAL PERITONITIS - EVIDENCE FOR INCREASED PERIPHERAL MICROVASCULAR PERMEABILITY ACCOMPANYING SYSTEMIC SEPSIS

  • 1 January 1985
    • journal article
    • research article
    • Vol. 97  (6) , 685-695
Abstract
The effects of systemic sepsis on peripheral microcirculatory fluid exchange were studied by examining changes in flow (.ovrhdot.Qlymph) and lymph-to-plasma [L/P] total protein and albumin ratios from lymph draining the efferent duct of a prefemoral lymph node in sheep, before and during surgically-induced peritonitis. After baseline study, peritonitis was produced by cecal ligation, perforation and devascularization. By 24 h blood cultures revealed a polymicrobial bacteremia. The hemodynamic response to the septic insult during the 72 h study period was characterized by an increase in heart rate and an initial fall in stroke volume index; the mean blood pressure remained unchanged from baseline levels throughout the study protocol. The intrapulmonary shunt fraction increased (P < 0.05) by 48 h, as did both the .ovrhdot.Qlymph (2.6 .+-. 1.9 ml/h to 6.8 .+-. 4.6 ml/h; P < 0.05) and the calculated lymph albumin clearance (1.6 .+-. 1.2 ml/h to 3.1 .+-. 1.7 ml/h; P < 0.05). Although the calculated serum to interstitial colloid osmotic pressure gradient fell (F = 4.37; P < 0.04), both the [L/P] total protein and albumin ratios were unchanged from baseline throughout 72 h of study. Further, [L/P] total protein ratios were unrelated to .ovrhdot.Qlymph (r = -0.20); as .ovrhdot.Qlymph (experimental/baseline) increased with sepsis, [L/P] total protein ratio (experimental/baseline) did not fall (r = +0.62). Systemic sepsis, as represented by this model of bacterial peritonitis, results in increased peripheral microcirculatory fluid flux that is primarily a consequence of an increase in permeability of the peripheral microvascular exchanging membrane.