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The effect of lung edema on pulmonary vasoactivity of furosemide

Authors
Journal
Journal of Surgical Research
0022-4804
Publisher
Elsevier
Publication Date
Volume
35
Issue
5
Identifiers
DOI: 10.1016/0022-4804(83)90027-6
Disciplines
  • Earth Science
  • Medicine

Abstract

Abstract Previous data suggest that furosemide improves gas exchange in pulmonary edema by preferential perfusion of nonedematous lung units. To test whether this is a direct effect of furosemide on the pulmonary vasculature as opposed to a secondary phenomenon resulting from the known peripheral effects of this drug, the effect of furosemide on the pressure-flow characteristics of the pulmonary vasculature was studied in six isolated perfused canine lungs with different degrees of gravimetrically determined edema. Furosemide shifted the pressure-flow curve by decreasing the mean intercept or average closing pressure of the pulmonary vascular bed from 13.8 ± 5.3 to 9.5 ± 5.4 cm H 2O and the zero-flow critical closing pressure from 9.3 ± 4.3 to 4.7 ± 3.5 cm H 2O ( P < 0.05). The slopes of these curves did not change between control and furosemide treatment. The decrease in intercept and the decrease in zero-flow critical closing pressures were closely correlated with the increase in edema ( r = −0.895 for average closing pressure and r = −0.928 for critical closing pressure) ( P < 0.05). Furosemide doubled the pulmonary blood flow in the isolated lobe for the same driving pressure and the greater the amount of lobar edema the less pronounced was this furosemide-associated increase in blood flow. This direct effect of furosemide on the pulmonary vasculature could explain the improved gas exchange seen before a decrease in pulmonary edema, since this pulmonary vasoactivity would result in preferential perfusion of nonflooded alveolar units.

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