Lung transvascular fluid dynamics with extracorporeal membrane oxygenation in unanesthetized lambs. 1979

A G Delaney, and W M Zapol, and A J Erdmann

Extracorporeal membrane oxygenation (ECMO) is used for long-term support of patients with acute respiratory failure. We investigated the effect of partial venoarterial (VA) and venovenous (VV) bypass with filler-free silicone spiral-coil membrane lungs on steady-state lung transcapillary fluid filtration in six unanesthetized lambs for periods of 11 to 32 hours. Using three thoracotomies we prepared animals to collect lung lymph; lymph obtained in this way is representative of lung interstitial fluid. By studying lymph flow and composition we demonstrated that the permeability of the pulmonary capillaries does not change during prolonged partial VV or VA bypass with a membrane lung. There was no accumulation of lung water during bypass, and lung protein and fluid leak neither increased not decreased with bypass flows equivalent to those used clinically. Thus prolonged use of ECMO in unanesthetized lambs appears to be neither harmful nor beneficial to the steady-state dynamics of fluid exchange in the lung. Furthermore, total pulmonary blood flow is not a determinant of net fluid filtration across the lung microcirculation.

UI MeSH Term Description Entries
D008168 Lung Either of the pair of organs occupying the cavity of the thorax that effect the aeration of the blood. Lungs
D008196 Lymph The interstitial fluid that is in the LYMPHATIC SYSTEM. Lymphs
D009997 Osmotic Pressure The pressure required to prevent the passage of solvent through a semipermeable membrane that separates a pure solvent from a solution of the solvent and solute or that separates different concentrations of a solution. It is proportional to the osmolality of the solution. Osmotic Shock,Hypertonic Shock,Hypertonic Stress,Hypotonic Shock,Hypotonic Stress,Osmotic Stress,Hypertonic Shocks,Hypertonic Stresses,Hypotonic Shocks,Hypotonic Stresses,Osmotic Pressures,Osmotic Shocks,Osmotic Stresses,Pressure, Osmotic,Pressures, Osmotic,Shock, Hypertonic,Shock, Hypotonic,Shock, Osmotic,Shocks, Hypertonic,Shocks, Hypotonic,Shocks, Osmotic,Stress, Hypertonic,Stress, Hypotonic,Stress, Osmotic,Stresses, Hypertonic,Stresses, Hypotonic,Stresses, Osmotic
D010107 Oxygenators, Membrane Devices in which blood and oxygen are separated by a semipermeable membrane, generally of Teflon or polypropylene, across which gas exchange occurs. The membrane may be arranged as a series of parallel plates or as a number of hollow fibers; in the latter arrangement, the blood may flow inside the fibers, which are surrounded by gas, or the blood may flow outside the fibers and the gas inside the fibers. (Dorland, 28th ed) Membrane Oxygenator,Membrane Oxygenators,Oxygenator, Membrane
D011506 Proteins Linear POLYPEPTIDES that are synthesized on RIBOSOMES and may be further modified, crosslinked, cleaved, or assembled into complex proteins with several subunits. The specific sequence of AMINO ACIDS determines the shape the polypeptide will take, during PROTEIN FOLDING, and the function of the protein. Gene Products, Protein,Gene Proteins,Protein,Protein Gene Products,Proteins, Gene
D011651 Pulmonary Artery The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. Arteries, Pulmonary,Artery, Pulmonary,Pulmonary Arteries
D011652 Pulmonary Circulation The circulation of the BLOOD through the LUNGS. Pulmonary Blood Flow,Respiratory Circulation,Circulation, Pulmonary,Circulation, Respiratory,Blood Flow, Pulmonary,Flow, Pulmonary Blood,Pulmonary Blood Flows
D011667 Pulmonary Veins The veins that return the oxygenated blood from the lungs to the left atrium of the heart. Pulmonary Vein,Vein, Pulmonary,Veins, Pulmonary
D001834 Body Water Fluids composed mainly of water found within the body. Water, Body
D002196 Capillaries The minute vessels that connect arterioles and venules. Capillary Beds,Sinusoidal Beds,Sinusoids,Bed, Sinusoidal,Beds, Sinusoidal,Capillary,Capillary Bed,Sinusoid,Sinusoidal Bed

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