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Alveolar-capillary membrane permeability. Correlation with functional, radiographic, and postmortem changes after

J G Jones, R F Grossman, M Berry

    The American Review of Respiratory Disease
    |August 1, 1979
    PubMed
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    Aspiration of hydrochloric acid significantly increased lung alveolar-capillary membrane permeability, leading to severe, persistent lung injury. Distilled water caused transient permeability changes, while saline had no effect.

    Area of Science:

    • Pulmonary Physiology
    • Membrane Transport
    • Toxicology

    Background:

    • The alveolar-capillary membrane's integrity is crucial for lung function.
    • Aspiration of gastric contents can lead to acute lung injury.
    • Quantifying membrane permeability changes is essential for understanding injury severity.

    Purpose of the Study:

    • To develop and validate an index for alveolar-capillary membrane permeability.
    • To assess the impact of aspirating saline, distilled water, and hydrochloric acid on this permeability index.
    • To correlate permeability changes with lung mechanics, gas exchange, and histological findings.

    Main Methods:

    • Derived a permeability index using two tracers (125I-antipyrine and 51Cr-ethylenediaminetetraacetate) in rabbits.

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  • Administered 2 ml/kg of saline, distilled water, or hydrochloric acid via aspiration.
  • Monitored permeability index, lung mechanics, gas exchange, chest roentgenograms, lung water, and histology.

    • Main Results:

    • Hydrochloric acid and distilled water significantly increased the permeability index; saline did not.
    • Hydrochloric acid caused persistent, severe lung injury with increased lung water and histological damage.
    • Distilled water caused transient permeability changes with minimal functional impact and no histological damage.

    Conclusions:

    • The derived permeability index effectively quantifies alveolar-capillary membrane injury.
    • Hydrochloric acid aspiration leads to severe, persistent lung injury, unlike transient effects of distilled water.
    • Persistent permeability increases correlate with significant lung water accumulation and functional deficits.