Compared effects of selected colloids on extravascular lung water in dogs after oleic acid-induced lung injury and severe hemorrhage.

Abstract

While the hemodynamic effects of hydroxyethyl starch (HES) have been reported, the effect of this material upon extravascular lung water (EVLW) has not been investigated. Twenty mongrel dogs were subjected to both an oleic acid-induced lung injury and a 2-h period of hemorrhagic shock (MAP = 40 mm Hg). After reinfusion of shed blood, 5 dogs in each of 4 groups were given either 0.5 L of lactated Ringer's solution or 0.5 L of 5% albumin, 6% dextran 75, or 6% HES. Lactated Ringer's solution was then given in sufficient quantity to keep the wedge pressure (WP) at 12-15 mm Hg and PaO2, P(A-a)O2, cardiac index (CI) and oxygen delivery were determined. EVLW was measured by thermal-green dye double-indicator technique with an Edwards Lung Water Computer (American Edwards Laboratories, Santa Ana, CA). Mean baseline EVLW was 6.9 +/- 0.3 ml/kg. Mean EVLW rose to 11.5 +/- 1.9 ml/kg after oleic acid. One h after reinfusion, EVLW increased to 40.5 +/- 4 ml/kg in the dogs given only lactated Ringer's solution and to 39.5 +/- 1.5 ml/kg in the dextran group. EVLW was 25.5 +/- 3 ml/kg in the HES dogs, and 29.5 +/- 2 ml/kg in the group given albumin. Differences between albumin and lactated Ringer's solution and between the HES and lactated Ringer's groups were significant (p less than 0.02 and p less than 0.05). Measurements of oxygen, ventilation, CI, and oxygen delivery were not significantly different between the albumin and HES subjects.