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1 Division of Pulmonary and Critical Care, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, USA
* To whom correspondence should be addressed. E-mail: dpearse{at}jhmi.edu.
Ventilation (V) increases lung lymph flow (QL) but the separate effects of tidal volume (VT) and frequency (f) and the role of ventilation-induced changes in edema formation are poorly understood. An isolated, in situ, sheep lung preparation was used to examine these effects. In 8 sheep with f = 10 min-1, results obtained during 30 min periods with VT = 5 or 20 ml.kg-1 were compared to values obtained during bracketed 30 min control periods (VT = 12.5 ml.kg-1). Eight other sheep with constant VT (12.5 ml.kg-1) were studied at f = 5 or 20 min-1 and compared to f = 10 min-1. Three additional groups of 6 sheep were perfused for 100 min with control V (10 ml.kg-1, 10 min-1). VT was then kept constant or changed to 20 or 3 ml.kg-1 during a second 100 min period. Increases in VT or f increased QL and vice-versa without corresponding effects on the rate of edema formation. For the same change in V, changing VT had a greater effect on QL than changing f. The
QL caused by an increase in VT was significantly greater after the accumulation of interstitial edema. The
QL caused by a sustained increase in VT was transient and did not correlate with the rate of edema formation suggesting that V altered QL through direct mechanical effects on edema-filled compartments and lymphatic vessels rather than through V-induced changes in fluid filtration.
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