Edema affects intra-alveolar fluid pressures and interdependence in dog lungs

The pressures in occluded, fluid-filled segments of lung were measured in closed-chest supine dogs ventilated with positive pressure at a constant tidal volume. Segment fluid pressures decreased in response to lung inflation and were used with esophageal and airway pressures to calculate an index of bronchiolar-parenchymal interdependence. Animals were subjected to three sequential 5% body wt infusions of Tyrode's solution followed by a 20- to 30 min-recovery period after each infusion. The interdependence index decreased significantly following each infusion, with infusions as small as 1% body wt producing a detectable decrease. The mean pressures in the Tyrode's solution-filled segments generally increased in response to the infusions, but the time course of the response was variable. The base-line pressure in Tyrode's solution-filled segments was -4.8 +/- 2.4 cmH2O. This increased to -1.1 +/- 2.7 cmH2O after a total of 15% body wt had been infused. At the same time, extravascular lung water increased by approximately 17%. Thus negative collapse pressures in the occluded segments were opposed by mechanical stresses transmitted through alveolar wall attachments. This counterbalancing stress was consistently reduced by both increased tissue hydration and increased pulmonary vascular pressure.