[Lung denervation. A study of therapy of shock lung]

It is the objective of this experiment to study the protective effect of pulmonary denervation in acute respiratory distress syndrome (shock lung). The experiments were performed by means of a model of pulmonary embolization with oleic acid in dogs. In the first series sequential tissue changes in the lung following oleic acid embolism are shown and the clinical changes are demonstrated. By a meticulous description of the anatomy of pulmonary innervation it is demonstrated that surgical denervation of the lung is only possible in the hilar area. A second series of experiments shows the effect of oleic acid embolism in animals after reimplantation of one lung. This means that the reimplanted lung is completely denervated. A description of the technique of pulmonary reimplantation is also given. It is stated that following oleic acid embolism, the reimplanted lung is less damaged than the contralateral innervated lung. In addition, animals with unilateral lung reimplantation have significantly better pulmonary function after oleic acid embolism than healthy animals with bilaterally innervated lungs. Finally, a technique of reversible bilateral denervation of the lung by transbronchial infiltration of both hili with a long acting local anaesthetic via bronchoscopy is described. Animals, whose lungs were denervated in this way were embolized with oleic acid. It could be shown that as long as the reversible denervation is effective there is no significant functional reaction following oleic acid embolism as compared to healthy and non-denervated animals.