Effects of intravenous pentafraction on lung and soft tissue liquid exchange in hypoproteinemic sheep.
Effects of infusing pentafraction (Pen), a synthetic hydroxyethyl starch plasma volume expander, on lung and soft tissue lymph flux were compared in nonanesthetized sheep that were protein depleted by batch plasmapheresis. Pen (5%) was infused to raise pulmonary arterial wedge pressure by 5 mmHg for 2 h (1.8 +/- 0.3 l). Pen raised plasma osmotic pressure from plasmapheresis baseline (10.7 +/- 2.2 mmHg; preplasmapheresis baseline, 19.6 +/- 0.6 mmHg) to 16.6 +/- 2.4 mmHg. After Pen, lung lymph flows peaked at 3.9 +/- 2.0 times a preplasmapheresis baseline value of 1.0 (plasmapheresis baseline, 2.7 +/- 0.7), but soft tissue lymph flows rose insignificantly. Plasma Pen concentrations were 2.3 +/- 1.0% postinfusion and 1.6 +/- 0.3% at 12 h. Pen mean molecular masses at these times, measured by high-performance liquid chromatography, were 160 +/- 44 and 129 +/- 23 kDa, respectively. In lung lymph, Pen concentrations were 0.8 +/- 0.6% postinfusion and 0.7 +/- 0.2% at 12 h, with mean molecular masses of 125 +/- 44 and 112 +/- 18 kDa, respectively. In soft tissue lymph Pen was nearly undetectable postinfusion, but at 12 h concentrations averaged 0.3 +/- 0.2% with a mean molecular mass of 80 +/- 10 kDa. The osmotic effectiveness of Pen may be related to its molecular mass, which was large enough to restrict filtration so that the plasma-to-lung lymph osmotic pressure gradient widened. Pen remained effective in the circulation for at least 24 h.
Conhaim
R L
RL
Department of Surgery, University of Wisconsin-Madison.
Rosenfeld
D J
DJ
Schreiber
M A
MA
Baaske
D M
DM
Harms
B A
BA
D000818:Animals; D001798:Blood Proteins / Q000187:drug effects / Q000378:metabolism*; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage / Q000494:pharmacology*; D007019:Hypoproteinemia / Q000097:blood / Q000503:physiopathology*; D007262:Infusions, Intravenous; D008168:Lung / Q000187:drug effects / Q000503:physiopathology*; D008196:Lymph / Q000187:drug effects / Q000502:physiology*; D008198:Lymph Nodes / Q000187:drug effects / Q000503:physiopathology*; D009997:Osmotic Pressure; D010952:Plasma Substitutes / Q000494:pharmacology*; D010956:Plasmapheresis; D011669:Pulmonary Wedge Pressure / Q000187:drug effects; D012756:Sheep
D001798:Blood Proteins; D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes