Journal of Applied Physiology, Vol 77, Issue 3 1155-1163, Copyright © 1994 by American Physiological Society

ARTICLES

Edema development and recovery in neurogenic pulmonary edema

M. B. Maron, P. H. Holcomb, C. A. Dawson, D. A. Rickaby, A. V. Clough and J. H. Linehan
Department of Physiology, Northeastern Ohio Universities College of Medicine, Rootstown, Ohio 44272.

We determined the time course of changes in extravascular lung water (EVLW) that occur after massive sympathetic activation produced by intracisternal veratrine administration in chloralose-anesthetized dogs. Three groups of dogs were studied. In the first group (n = 9), acute increases in EVLW (occurring within minutes) were determined both by measuring extravascular thermal volume and by gravimetric analysis. In the second (n = 6) and third (n = 7) groups, changes in EVLW were followed for 2-3 h after veratrine administration. Extravascular thermal volume was measured in the second group. In the third group, right atrial injections of a vascular indicator (125I-labeled serum albumin) and an extravascular indicator (3HOH) were made while blood was sampled from the pulmonary artery (PA) and left atrium, and EVLW was determined by deconvolution of the left atrial and PA concentration-time curves. Indicator-dilution and gravimetric EVLW increased acutely only in dogs in which PA pressure exceeded 60 Torr, with two- to four-fold increases in EVLW being observed in dogs that developed the highest PA pressures (maximum 94 Torr). Thus, severe edema can develop rapidly after massive sympathetic nervous system activation but requires extreme degrees of pulmonary hypertension. In several dogs after the acute increase in EVLW associated with the pulmonary hypertension, the indicator-dilution EVLW decreased with time. These decreases appear to effect clearance of edema fluid rather than alterations in perfusion.

This article has been cited by other articles:

				C. A. Piantadosi and D. A. Schwartz The Acute Respiratory Distress Syndrome Ann Intern Med, September 21, 2004; 141(6): 460 - 470. [Full Text] [PDF]

				S. J. Fletcher and J. D. Atkinson Use of prone ventilation in neurogenic pulmonary oedema Br. J. Anaesth., February 1, 2003; 90(2): 238 - 240. [Abstract] [Full Text] [PDF]

				D. L. Roerig, S. H. Audi, J. H. Linehan, G. S. Krenz, S. B. Ahlf, W. Lin, and C. A. Dawson Detection of changes in lung tissue properties with multiple-indicator dilution J Appl Physiol, June 1, 1999; 86(6): 1866 - 1880. [Abstract] [Full Text] [PDF]

				H. Duplain, L. Vollenweider, A. Delabays, P. Nicod, P. Bartsch, and U. Scherrer Augmented Sympathetic Activation During Short-Term Hypoxia and High-Altitude Exposure in Subjects Susceptible to High-Altitude Pulmonary Edema Circulation, April 6, 1999; 99(13): 1713 - 1718. [Abstract] [Full Text] [PDF]

				Y. Berthiaume, O. Lesur, and A. Dagenais Treatment of adult respiratory distress syndrome: plea for rescue therapy of the alveolar epithelium Thorax, February 1, 1999; 54(2): 150 - 160. [Full Text]

				M. B. Maron Dose-response relationship between plasma epinephrine concentration and alveolar liquid clearance in dogs J Appl Physiol, November 1, 1998; 85(5): 1702 - 1707. [Abstract] [Full Text] [PDF]

				S. M. LANE, K. C. MAENDER, N. E. AWENDER, and M. B. MARON Adrenal Epinephrine Increases Alveolar Liquid Clearance in a Canine Model of Neurogenic Pulmonary Edema Am. J. Respir. Crit. Care Med., September 1, 1998; 158(3): 760 - 768. [Abstract] [Full Text] [PDF]