Early changes in lung water after haemorrhagic shock in pigs and dogs

This study has demonstrated a 34 per cent rise in lung water after shock and retransfusion of blood. This extra lung water was associated with increased pulmonary artery pressure, increased plumonary vascular resistance and reduced myocardial performance. These findings occurred despite the failure of arterial pressure to return to normal after retransfusion blood. Although this increased lung water is less than anything which can be detected clinically it may represent the beginnings of the shock lung syndrome as oedema progresses over period of weeks. A reasonable approach to the problem should include attempts to reduce the elevated plumonary vascular resistance. NaHCO3 should be infused before or during administration of the first bottle of blood in an attempt to improve myocardial function and reduce pulmonary vascular resistance. Fluids should not be infused simply to return arterial pressures in the pulmonary vascular bed. Pulmonary artery and wedge pressure monitoring with Swan Ganz catheters may improve the management of shock patients.