RESPONSE OF THE PULMONARY MICRO-CIRCULATION TO FLUID LOADING AFTER HEMORRHAGIC-SHOCK AND RESUSCITATION

  • 1 January 1980
    • journal article
    • research article
    • Vol. 87  (5) , 552-559
Abstract
The response of the pulmonary microcirculation was compared to fluid overload before and 24 h after hemorrhagic shock, resuscitated with blood or crystalloid, to determine whether vascular permeability was altered, making the lung more susceptable to fluid overload after shock and whether this response differed depending on the type of resuscitation fluid. Unanesthetized sheep (14) with chronic lung lymph fistula were given a fluid challenge (1/2 of blood vol) before and 24 h after hemorrhagic shock. Sheep (7) were resuscitated after shock with shed blood and 7 sheep were resuscitated with Ringer''s lactate alone, equal to 2.5 times the amount of shed blood. Pulmonary vascular pressures and lung lymph flow .ovrhdot.QL were at baseline in both groups 24 h after resuscitation, except for the decreased plasma oncotic pressure .pi.p in the crystalloid group. Interstitial oncotic pressure, .pi.i was also lowered in this group such that the gradient (.pi.p-.pi.i) remained at baseline. In the blood group, pulmonary vascular pressures and .ovrhdot.QL increased transiently after fluid loading before and after shock with the mean time for .ovrhdot.QL to return to baseline being 5.5 and 5.9 h for the preshock and postshock periods, respectively. In the crystalloid group, fluid loading after shock produced an increase in pulmonary vascular pressures resulting in a significant increase in .ovrhdot.QL over the preshock fluid response with the mean time for .ovrhdot.QL to return to baseline being 10.1 h. Changes in the value of (.pi.p-.pi.i) were identical to those seen before shock. Lung permeability was not significantly altered 24 h after shock, but crystalloid resuscitation did make the lung more susceptible to volume overload. [The determination of the cause of posttraumatic respiratory insufficiency was attempted].

This publication has 1 reference indexed in Scilit: