Lung microvascular transport properties measured by multiple indicator dilution methods in patients with adult respiratory distress syndrome. A comparison between patients reversing respiratory failure and those failing to reverse

Journal Article · Thu Feb 01 00:00:00 EST 1990 · American Review of Respiratory Disease (New York); (USA)

DOI:https://doi.org/10.1164/ajrccm/141.2.272· OSTI ID:7025947

Harris, T R; Bernard, G R; Brigham, K L; Higgins, S B; Rinaldo, J E; Borovetz, H S; Sibbald, W J; Kariman, K; Sprung, C L ^[1]

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1. Vanderbilt Univ., Nashville, TN (USA)

We conducted indicator dilution studies on the lungs of patients in the early phases of adult respiratory distress syndrome (ARDS) to test the hypothesis that capillary permeability was increased in patients with respiratory failure. Indicator dilution studies were performed using 51Cr-erythrocytes, 125I-albumin, 14C-urea, and 3H-water as tracers. The injectate was infused as a bolus into a central venous line. Peripheral arterial blood was collected and counted for radioactivity. Mathematical analysis of the indicator curves yielded cardiac output, measures of the product of capillary permeability and surface area for urea (PS and D1/2S), the intravascular lung volume (Vv), and the extravascular lung water volume (Ve). Permeability was separated from surface area by normalizing PS and D1/2S to Vv. Patients could be divided into 16 in whom blood gas determinations and radiologic criteria for ARDS were reversed and 23 in whom they were not. We examined indicator dilution and other measures of lung function in the two groups to determine whether significant differences in microvascular function existed. PS and PS/Vv were significantly higher in the nonreversal patients. Ve was above normal, but not different between groups. Linear regression analysis showed significant correlations for all of the following in the nonreversal group: Ve and all measures of permeability, pulmonary vascular resistance (PVR), and the inverse of permeability-surface area measures and AaDO2 and PVR. Only measures of Ve and PS correlated in the reversal group. These results support the hypothesis that capillary permeability is increased in patients with early ARDS and continuing respiratory failure.

• OSTI ID: 7025947
• Journal Information: American Review of Respiratory Disease (New York); (USA), Vol. 141:2; ISSN 0003-0805
• Country of Publication: United States
• Language: English

Related Subjects

59 BASIC BIOLOGICAL SCIENCES
CAPILLARIES
PERMEABILITY
LUNGS
DYNAMIC FUNCTION STUDIES
RESPIRATORY SYSTEM DISEASES
PATHOGENESIS
ALBUMINS
CARBON 14 COMPOUNDS
CHROMIUM 51
ERYTHROCYTES
IODINE 125
ISOTOPE DILUTION
MAN
PATIENTS
TRACER TECHNIQUES
TRITIUM COMPOUNDS
UREA
AMIDES
ANIMALS
BETA DECAY RADIOISOTOPES
BIOLOGICAL MATERIALS
BLOOD
BLOOD CELLS
BLOOD VESSELS
BODY
BODY FLUIDS
CARBONIC ACID DERIVATIVES
CARDIOVASCULAR SYSTEM
CHROMIUM ISOTOPES
DAYS LIVING RADIOISOTOPES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
EVEN-ODD NUCLEI
HYDROGEN COMPOUNDS
INTERMEDIATE MASS NUCLEI
IODINE ISOTOPES
ISOTOPE APPLICATIONS
ISOTOPES
LABELLED COMPOUNDS
MAMMALS
MATERIALS
NUCLEI
ODD-EVEN NUCLEI
ORGANIC COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
ORGANS
PRIMATES
PROTEINS
RADIOISOTOPES
RESPIRATORY SYSTEM
VERTEBRATES
550901* - Pathology- Tracer Techniques