title: Aspiration pneumonia: treatment with osmotically active agents.
abstract: Utilizing the ex vivo perfused ventilated canine pulmonary lobe, we evaluated the effects of three osmotically active agents on pulmonary function after acid aspiration. Control lobes were stable during a 44-hour perfusion with minimal weight gain, stable pulmonary artery and end-inspiratory pressures, and no increase in intrapulmonary shunting. After acid aspiration during a 44-hour perfusion period, massive weight gain occurred (228 gm), pulmonary artery and end-inspiratory pressure increased, and marked intrapulmonary shunting (44%) developed. When mannitol (molecular weight 182) or dextran 40 (molecular weight 40,000) were added to the perfusate of the acid-instilled lobes, no significant modifications of the acid-induced response were seen during the 44-hour perfusion. The administration of albumin (molecular weight 69,000), however, markedly modified the acid-induced response. Weight gain (53 gm) was almost completely eliminated, pulmonary artery and end-inspiratory pressures were stable, and intrapulmonary shunting increased only minimally (10%). It is concluded that despite the permeability change in the capillary-alveolar membrane produced by acid aspiration, albumin is retained within the vascular space and is effective in reducing the injury response.
mesh_terms: D000403:Airway Resistance; D000418:Albumins / Q000627:therapeutic use*; D000818:Animals; D001794:Blood Pressure; D003911:Dextrans / Q000627:therapeutic use*; D004285:Dogs; D008168:Lung / Q000473:pathology; D008353:Mannitol / Q000627:therapeutic use*; D009929:Organ Size; D009995:Osmosis; D011015:Pneumonia, Aspiration / Q000188:drug therapy*; D011651:Pulmonary Artery / Q000503:physiopathology; D013997:Time Factors
chemical_list: D000418:Albumins; D003911:Dextrans; D008353:Mannitol