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Permeability pulmonary edema following lung resection.
M Mathru1, B Blakeman, D J Dries
1Department of Anesthesia Research, Loyola University Medical Center, Maywood, IL.
Chest
|November 1, 1990
Summary
Post-pulmonary resection, patients developed severe pulmonary edema due to increased pulmonary capillary pressure and alveolar-capillary membrane injury. This indicates permeability changes contributing to fluid accumulation in the lungs.
Area of Science:
- Cardiology
- Pulmonary Medicine
- Critical Care Medicine
Background:
- Pulmonary resection can lead to postoperative pulmonary edema.
- The underlying mechanisms require further investigation.
Purpose of the Study:
- To investigate the etiology of edema in patients following pulmonary resection.
- To identify key factors contributing to pulmonary edema in the early postoperative period.
Main Methods:
- Studied five patients post-pulmonary resection (pneumonectomy or lobectomy).
- Collected hemodynamic data using pulmonary and radial artery catheters.
- Analyzed edema fluid and serum for protein and albumin content.
- Calculated shunt fraction.
Main Results:
- All patients exhibited severe respiratory distress and diffuse interstitial pulmonary edema within 12 hours.
- Patients had normal to high cardiac output with normal filling pressures.
- Edema fluid to serum protein ratio was ≥0.6, suggesting increased capillary permeability.
- Calculated shunt fraction exceeded 25% in all patients.
Conclusions:
- Post-pulmonary resection edema is linked to increased pulmonary capillary pressure in a reduced vascular bed.
- Alveolar-capillary membrane injury, indicated by high edema fluid protein, is a significant factor.
- These permeability changes contribute to edema accumulation.