Severe @entity3126 sometimes develops despite normal pulmonary capillary wedge pressure (Ppw). The equation describing net transvascular flux of lung liquid predicts decreased @entity4 when hydrostatic pressure is reduced or when colloid osmotic pressure is increased in the pulmonary vessels. We tested these predictions in a model of pulmonary capillary leak produced in 35 @entity235 by intravenous @entity3952 . 1 h later, the @entity235 were divided into five equal groups and treated for 4 h in different ways: (a) not treated, to serve as the control group (Ppw = 11.1 mm Hg); (b) given albumin to increase colloid osmotic pressure by 5 mm Hg (Ppw = 10.6 mm Hg); (c) ventilated with 10 cm @entity4358 positive end-expiratory pressure (Peep) (transmural Ppw = 10.4 mm Hg); (d) phlebotomized to reduce Ppw to 6 mm Hg; (e) infused with @entity1854 , which also reduced Ppw to 6 mm Hg. Phlebotomy and @entity1854 reduced the @entity4 in excised lungs by 50% (P< 0.001), but Peep and albumin did not affect the @entity4 . Pulmonary shunt decreased on Peep and increased on @entity1854 , and lung compliance was not different among the treatment groups, demonstrating that these variables are poor indicators of changes in @entity4 . Cardiac output decreased during the treatment period in all but the @entity1854 group, where Ppw decreased and cardiac output did not. We conclude that @entity235 @entity3952 @entity3126 is reduced by small reductions in hydrostatic pressure, but not by increased colloid osmotic pressure, because the vascular permeability to liquid and protein is increased. These results suggest that low pressure @entity3126 may be reduced by seeking the lowest Ppw consistent with adequate cardiac output enhanced by vasoactive agents like @entity1854 . Further, colloid infusions and Peep are not helpful in reducing @entity4 , so they may be used in the lowest amount that provides adequate circulating volume and arterial @entity3612 saturation on nontoxic inspired @entity3612 . Until these therapeutic principles receive adequate clinical trial, they provide a rationale for carefully monitored @entity65 in treating @entity1 with pulmonary capillary leak.

Treatment of acute low pressure @entity3126 in XXXX : relative effects of hydrostatic and oncotic pressure, @entity1854 , and positive end-expiratory pressure.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity3952 :: ('MESH:D019301', 'Chemical') :: ['oleic acid'] @entity3126 :: ('MESH:D011654', 'Disease') :: ['pulmonary edema'] @entity235 :: ('9615', 'Species') :: ['canine', 'dogs'] @entity4 :: ('MESH:D004487', 'Disease') :: ['edema'] @entity4358 :: ('D014867', 'Chemical') :: ['H(2)O'] @entity1854 :: ('MESH:D009599', 'Chemical') :: ['nitroprusside'] @entity3612 :: ('D013481', 'Chemical') :: ['O(2)'] @entity65 :: ('MESH:D002318', 'Disease') :: ['cardiovascular manipulation']
@entity235 :: (9615,Species) :: ['dogs']
