The effect of increased vascular pressure on albumin-excluded volume and lymph flow in the dog lung

Abstract

We studied the effects of steady state increases in left atrial pressure on the albumin-excluded volume in the lungs of mongrel dogs. We estimated the tissue blood volume using 51Cr-labeled red cells, the extracellular space using 99mTc-DTPA (diethylene triamine pentacetic acid), and the albumin space using 125I-labeled human serum albumin. An afferent lymphatic to the left tracheobronchial node was cannulated for measurement of lymph flow, total protein and albumin concentration. Total extravascular water (Qw), extravascular 99mTc-DTPA space, extravascular albumin content, and albumin space were calculated in lung tissue samples taken during a baseline period and during steady states, following increases in pulmonary capillary pressure. Lymph flow increased by 0.20-fold, and Qw by 0.05 g/g blood free dry weight for each cm H2O increase in capillary pressure over the range of capillary pressures used in this study. Using an extravascular albumin space based on the concentration of albumin in lymph, an excluded albumin volume of 36% of the extravascular 99mTc-DTPA space was calculated for normally hydrated lungs. This excluded volume fraction decreased to approximately 10% of the extravascular 99mTc-DTPA space at capillary pressures above 30 cm H20. Oncotic buffering increased the plasma to lymph colloid osmotic pressure gradient, and buffered approximately 29% of the increase in pulmonary capillary pressure. Excluded volume had a simple physiochemical relationship to tissue hydration. It also served as a 'safety factor' against pulmonary edema because there was a greater increase in available volume that total interstitial fluid volume during edema formation. Oncotic buffering then could occur with a smaller increase in interstitial fluid volume than would otherwise be possible.