Pulmonary Acid Injury

Abstract

Pulmonary acid aspiration results in hypoxemia and hypovolemia. We assessed the effects of positive end-expiratory pressure (PEEP) and fluid resuscitation on oxygenation and alveolar-capillary membrane permeability after acid aspiration. Alveolar-capillary membrane permeability was assessed by determination of extravascular lung water volume, using the thermal-green dye double-indicator technique, extravasation of iodinated 1 125 serum albumin into lung parenchyma, and albumin leak into the alveolar spaces. The data from this study demonstrated that PEEP improved oxygenation after acid aspiration, but did not alter progression of the injury; cardiac output and oxygen transport were improved by plasma volume repletion while receiving PEEP; and resuscitation with 5% albumin solution increased plasma albumin content and tracheal albumin content commensurately and did not modify progression of the injury.