Dynamic Insufficiency of Lung Lymph Flow from the Right Lymph Duct in Dogs with Acute Filtration Edema 1,2

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Abstract
Using 14 anesthetized dogs with lymph flowing through right lymph duct, we observed dynamic insufficiency of lung lymph flow during acute left atrial pressure loading. Net pulmonary microvascular fluid filtration pressure (Σp) was defined as the difference between pulmonary microvascular pressure (Pmv) and oncotic gradient through the capillaries (πrnv - πpmv). Pulmonary extravascular water content (PEVW) was well correlated with Σp in either mild edema or gross edema (PEVW = 0.19 Σp + 2.15, r = 0.813, 0.001 < p < 0.002). Percent increase in lymph flow (%lym) was well correlated with both PEVW (%lym = 130.8 PEVW - 376.5, r = 0.886,0.005 < p < 0.01) and Σp (%lym = 11.0 Σp + 34.7, r = 0.853, 0.02 < p < 0.05) in mild edema. However, in gross edema compared with mild edema, %lym as a function of PEVW or Σp was significantly low. We concluded that in gross edema with PEVW, over 6 g/g of bloodless dry lung and Σp over 20 mmHg, lymph flow from right lymph duct becomes dynamically insufficient and can neither transport enough fluid from the pulmonary interstitium nor tracheobronchial trees to relieve the edema process.

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