ASPIRATION PNEUMONIA - TREATMENT WITH OSMOTICALLY ACTIVE AGENTS

  • 1 January 1981
    • journal article
    • research article
    • Vol. 89  (5) , 588-593
Abstract
Utilizing the ex vivo perfused ventilated canine pulmonary lobe, the effects of 3 osmotically active agents on pulmonary function after acid aspiration were evaluated. Control lobes were stable during a 44 h perfusion with minimal weight gain, stable pulmonary artery and end-inspiratory pressures, and no increase in intrapulmonary shunting. After acid aspiration during a 44 h perfusion period, massive weight gain occurred (228 g), pulmonary artery and end-inspiratory pressure increased, and marked intrapulmonary shunting (44%) developed. When mannitol (MW 182) or dextran 40 (MW 40,000) were added to the perfusate of the acid-instilled lobes, no significant modifications of the acid-induced response were seen during the 44 h perfusion. The administration of albumin (MW 69,000) markedly modified the acid-induced response. Weight gain (53 g) was almost completely eliminated, pulmonary artery and end-inspiratory pressures were stable, and intrapulmonary shunting increased only minimally (10%). Despite the permeability change in the capillary-alveolar membrane produced by acid aspiration, albumin is retained within the vascular space and is effective in reducing the injury response.

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