Effect of defibrinogenation on lung fluid and protein exchange after glass bead embolization.

JOHNSON, ARNOLD, AND ASRAR B. MALIK. Effect of defybrinogenation on Lung fluid and protein exchange after glass bead embokation. J. Appl. Physiol.: Respirat. Environ. Exercise Physiol. 53(4): 895-900, 1982.-We examined the basis of the protective effect of defibrinogenation in dogs in preventing pulmonary edema following embolization with glass beads (A. Johnson and A. B. Malik, J. Appl. Physiol.: Respirat. Environ. Exercise PhysioZ. 49: 841-845,198O). Studies were made in four groups of sheep prepared with the lung lymph fistulas. Group I were normal animals in which pulmonary lymph flow (Qlym) was increased by inflation of a Foley balloon catheter in the left atrium. Group 11 were control animals that were embolized with plain glass beads (mean t SE, 0.46 & 0.04 g/kg) to raise pulmonary arterial pressure (Ppa) threefold above base line. Group III were defibrinogenated with ancrod (0.70 NIH U kg-’ *day-‘) for 3 days, and then the pulmonary vascular bed was embolized with the same dose of beads as group II. Group IV were also defibrinogenated but received enough beads (0.78 t 0.07 g/kg) to raise the Ppa to the same level (3-fold) as group 11. The Qlym increased without a change in the lymph-toplasma protein concentration ratio (L/P) after embolization in groups II, III, and IV, whereas the increase in Qlym in group 1 was associated with a decrease in L/P. Therefore, defibrinogenation did not prevent the glass bead microembolizationinduced increase in lung vascular permeability. Group 111 had smaller increases in Ppa than both groups II and IV following embolization. The extravascular lung water/g lung wt was less in group III compared with the control value, but the value in group IV was not different from control. It is concluded that defibrinogenation does not prevent the increase in permeability following embolization with glass beads; however, defibrinogenation prevents pulmonary edema if the same number of glass beads are injected as in control group. The protective effect may be due to a smaller increase in the pulmonary microvascular pressure in the defibrinogenated animals.