Original communication| Volume 72, ISSUE 5, P780-788, November 1972

Pulmonary intravascular and extravascular volumes in hemorrhagic shock and fluid replacement

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      Extravascular lung water, measured by the double-indicator dilution technique, did not decrease as did pulmonary blood volume and total blood volume in dogs subjected to hemorrhagic shock. Resuscitation by reinfusion of the shed blood or lactated Ringer's solution restored pulmonary blood volume to control level but never fully restored total blood volume. Pulmonary extravascular water was significantly increased by infusion of lactated Ringer's solution but was not appreciably altered by reinfusion of shed blood. Alteration of the transcapillary pressure gradient in a direction favoring fluid diffusion after lactated Ringer's solution is proposed as the mechanism for the increase in extravascular lung water. Resuscitation of hemorrhagic shock with fluid aimed at preserving the transcapillary pressure gradient is suggested to prevent the formation of pericapillary fluid in the lungs.
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