Rebreathing pulmonary capillary and tissue volume in normals after saline infusion

A rebreathing technique was utilized to assess changes in diffusing capacity (DCO), pulmonary capillary blood volume (Vc), pulmonary parenchymal tissue volume (Vt), and cardiac output (Qc), after infusion of 2 liters of 0.9% saline intravenously in 13-25 min in five healthy subjects. Blood hemoglobin concentration decreased an average of 17%. Vc increased strikingly in all five subjects. No significant changes in Vt, or in Vt per unit lung volume were observed. Radiographic evidence of interstitial pulmonary edema was present in four of the five subjects. Radiographic total lung capacity was reduced significantly in four of the five subjects. Significant reductions in forced vital capacity (FVC), forced expiratory volume in 1.0 and 3.0 s, and mean forced expiratory flow during the middle half of the FVC occurred in three of the five subjects. No dyspnea, cough, or physical examination abnormalities of lungs or heart occurred. This noninvasive, ventilation-limited, rebreathing technique appears capable of detecting early changes in pulmonary congestion, at a time when definitive radiographic changes and changes in the physical examination are absent. It appears capable of detecting the increase in Vc associated with hypervolemia in man.