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Ann Thorac Surg 1994;57:708-714
© 1994 The Society of Thoracic Surgeons

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Articles

Changes in vascular permeability with ischemic time, temperature, and inspired oxygen fraction in isolated rabbit lungs

Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri USA

Accepted for publication June 25, 1993.

^_* Address reprint requests to Dr Cooper, Division of Cardiothoracic Surgery, Washington University, Suite 3108, Queeny Tower, One Barnes Hospital Plaza, St. Louis, MO 63110.

The capillary filtration coefficient (K_f) is one of the most accurate measures of change in pulmonary vascular permeability and has been used in various models of acute lung injury. To evaluate the isolated effects of ischemia on K_f, we have developed an ex vivo rabbit lung model in which the influences of reperfusion are eliminated. The current study was designed to validate this model by determining the effect of cold flushing with low-potassium-dextran solution containing 1% glucose (LPDG), ischemic time, temperature, and inspired oxygen fraction on K_f. On completion of the ischemic period, the ventilated lungs, with the heart still attached, were suspended from a strain-gauge force transducer. After the lungs were flushed with 50 mL hetastarch solution (6% hetastarch solution with physiologic saline solution), the left atrial drainage cannula was occluded and the pulmonary artery pressure was incrementally increased by elevation of the reservoir. The K_f was calculated as the slope of the line relating the weight gain rate and pulmonary capillary pressure. Our study demonstrated the following: (1) K_f was not altered by flushing the lungs with LPDG at either 1 °C or 10 °C; (2) preservation at 37 °C, even for only 2 hours, demonstrated severe deterioration in K_f; (3) although hypothermia during ischemia suppressed the deterioration of K_f, there were no significant differences in K_f between 1 °C and 10 °C when ischemic time was less than 24 hours; (4) when preservation lasted less than 8 hours, change in K_f was not influenced by the differences in inspired oxygen fraction during the ischemic period; (5) during 24-hour preservation, K_f increased less when the lungs were inflated with room air than when they were inflated with either 100% oxygen or 100% nitrogen. These results indicate that injury occurs primarily during ischemia and increases with ischemic lime even in lungs flushed with LPDG and kept at 1 °C or 10 °C. Inflation with 100% oxygen may cause injury of the pulmonary vascular endothelium during 24-hour preservation, although oxygen supply from airway is essential. This isolated, ex vivo rabbit model examining pulmonary vascular permeability provides a sensitive and reliable means for evaluation of ischemic injury of the preserved lung.

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