DECREASED PULMONARY TRANSVASCULAR FLUID FILTRATION IN AWAKE NEWBORN LAMBS AFTER INTRAVENOUS FUROSEMIDE
DECREASED PULMONARY TRANSVASCULAR FLUID FILTRATION IN AWAKE NEWBORN LAMBS AFTER INTRAVENOUS FUROSEMIDE
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DOI：
10.1172/jci109166
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发表时间：
1978-01-01
影响因子：
15.9
通讯作者：
BRESSACK, MA
中科院分区：
文献类型：
--
作者：
BLAND, RD;MCMILLAN, DD;BRESSACK, MA
我们通过测量 9 只 1 周龄未麻醉羔羊在快速静脉输注速尿（10 次实验中为 1 mg/kg，5 次实验中为 8 mg/kg）之前和之后的稳态肺淋巴流量和蛋白流量、肺动脉和左心房压力，研究了速尿对液体肺经血管滤过和微血管对血浆蛋白通透性的影响。随着呋塞米诱导的快速利尿（尿流量增加八倍），肺血管压力降低，淋巴液和血浆蛋白浓度增加，并且淋巴液流量和淋巴蛋白流量一致减少，较大剂量后更明显。另外 5 只羔羊在出现盐水诱导的肺水肿的情况下静脉注射 8 mg/kg 的呋塞米；在这些实验中，血管压力的降低、经血管蛋白质梯度的增加以及淋巴流量的减少均大于没有肺水肿的羔羊。这些发现表明，呋塞米通过减小经血管液压梯度和增加经血管蛋白质渗透压梯度来减少肺中液体的经血管过滤。在对摘除肾脏的麻醉羔羊进行的五项急性实验中，静脉注射 8 毫克/千克的呋塞米使淋巴流量减少了一半，而肺血管压力或蛋白质浓度没有变化。在没有肾脏的羔羊身上进行的实验结果与肺中用于液体和蛋白质交换的血管表面积的减少一致。
We studied the effect of furosemide on pulmonary transvascular filtration of fluid and microvascular permeability to plasma proteins by measuring steady-state lung lymph flow and protein flow, pulmonary arterial and left atrial pressures in nine 1-wk-old unanesthetized lambs before and after rapid intravenous infusion of furosemide, 1 mg/kg in 10 experiments and 8 mg/kg in 5 experiments. With rapid diuresis induced by furosemide (an eightfold increase in urine flow), lung vascular pressures decreased, protein concentrations of lymph and plasma increased, and there was a consistent decrease in lymph flow and lymph protein flow, more pronounced after the larger dose. Five additional lambs received 8 mg/kg of furosemide intravenously in the presence of saline-induced pulmonary edema; in these experiments, the decrease in vascular pressures, increase in transvascular protein gradient, and decrease in lymph flow were greater than in lambs without pulmonary edema. These findings suggest that furosemide decreases transvascular filtration of fluid in the lung by diminishing the transvascular hydraulic pressure gradient and increasing the transvascular gradient for protein osmotic pressure. In five acute experiments on anesthetized lambs with kidneys removed, 8 mg/kg of intravenous furosemide decreased lymph flow one-half as much as it did in the presence of kidneys, with no change in lung vascular pressures or protein concentrations. The results of experiments in lambs without kidneys are consistent with a reduction in the vascular surface area for exchange of fluid and protein in the lung.