The mass balance method for estimating transcapillary protein transport in an extremity

A 'clinical' procedure for applying the mass balance method to estimate transcapillary protein transport was compared with the 'experimental' procedure of direct tissue monitoring of the rate of 125I-albumin accumulation in the dog hindlimb under conditions of venous pressure (Pv) elevation, norepinephrine infusion, and hemorrhagic hypotension. Over a wide range of venous protein flux (0.2 to 4.6 mg/min X 100 gm), the two estimates correlated well. The correlation coefficients were 0.987, 0.962, and 0.993 for Pv elevation in the control state, during norepinephrine infusion, and following hemorrhage, respectively. Since the 'clinical' format requires only estimates of tissue blood flow, the change in tissue volume, and the change in protein concentration easily obtained with strain gauge plethysmography and venous blood sampling, it represents a relatively innocuous procedure for estimating protein transport which should be suitable for clinical application.