title: Lymphatic pump treatment increases thoracic duct lymph flow in conscious dogs with edema due to constriction of the inferior vena cava.
abstract: BACKGROUND
  Osteopathic lymphatic pump treatments (LPT) are used to treat edema, but their direct effects on lymph flow have not been studied. In the current study, we examined the effects of LPT on lymph flow in the thoracic duct of instrumented conscious dogs in the presence of edema produced by constriction of the inferior vena cava (IVC).
  
  
  RESULTS
  Six dogs were surgically instrumented with an ultrasonic flow transducer on the thoracic lymph duct and catheters in the descending thoracic aorta and in IVC. After postoperative recovery, lymph flow and hemodynamic variables were measured 1) pre-LPT, 2) during 4 min LPT, 3) post-LPT, in the absence and presence of edema produced by IVC constriction. This constriction increased abdominal girth from 60 +/-2.6 to 75 +/- 2.9 cm. Before IVC constriction, LPT increased lymph flow (P < 0.05) from 1.9 +/- 0.2 ml/min to a maximum of 4.7 +/-1.2 ml/min, whereas after IVC constriction, LPT increased lymph flow (P < 0.05) from 7.9 +/-2.2 to a maximum of 11.7 +/-2.2 ml/min. The incremental lymph flow mobilized by 4 min of LPT (ie, the flow that exceeded 4 min of baseline flow), was 10.6 ml after IVC constriction. This incremental flow was not significantly greater than that measured before IVC constriction.
  
  
  CONCLUSIONS
  Edema caused by IVC constriction markedly increased lymph flow in the thoracic duct. LPT increased thoracic duct lymph flow before and after IVC constriction. The lymph flow mobilized by 4 min of LPT in presence of edema was not significantly greater than that mobilized prior to edema.
authors.affiliation: Department of Integrative Physiology, University of North Texas Health Science Center, Fort Worth, Texas 76107, USA.
authors.forename: Parna
authors.initials: P
authors.lastname: Prajapati
authors.forename: Pankhil
authors.initials: P
authors.lastname: Shah
authors.forename: Hollis H
authors.initials: HH
authors.lastname: King
authors.forename: Arthur G
authors.initials: AG
authors.lastname: Williams
authors.forename: Pratikkumar
authors.initials: P
authors.lastname: Desai
authors.forename: H Fred
authors.initials: HF
authors.lastname: Downey
mesh_terms: D000005:Abdomen / Q000473:pathology; D000818:Animals; D001013:Aorta, Thoracic / Q000503:physiopathology; D002404:Catheterization; D003243:Consciousness; D003251:Constriction, Pathologic / Q000150:complications; D004285:Dogs; D004487:Edema / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D008196:Lymph / Q000502:physiology*; D008208:Lymphatic System / Q000503:physiopathology; D008297:Male; D026301:Manipulation, Osteopathic / Q000379:methods; D013897:Thoracic Duct / Q000503:physiopathology*; D014682:Vena Cava, Inferior / Q000473:pathology / Q000503:physiopathology*