Post-pneumonectomy pulmonary edema (PPE) is a well-known postoperative complication, occurring in 8-10% of cases, with a high mortality rate of 60-80%. The cause of PPE has been extensively investigated and is widely believed to be multifactorial. An alteration in permeability and dilatation of alveolocapillary membrane pore diameter may contribute to the pathophysiology of PPE. The aim of this study was to determine dilatation of pore diameter after pulmonary resection.
Pulmonary resection was performed in twenty laboratory rats. Two hours prior to the pulmonectomy, fluorescein-isothiocyanate dextran 70,000 was injected. The concentration of dextran in the remaining and resected (control group) lung tissue was determined by the fluorescence method.
The concentration of dextran was significantly higher in the remaining lung tissue, mean value 0.046, as compared to the control group (0.0278), p=0.001.
Dextran is larger than alveolocapillary membrane pore diameter. Therefore the significant increase in the concentration of dextran in the remaining lung tissue after pulmonary resection indicates alterations in membrane permeability, an increase in alveolocapillary membrane pore diameter, and a possible contribution to the pathophysiology of PPE.
If pulmonary alveolocapillary membrane pore diameter increases after resection, thus contributing to PPE, the treatment should be focused on these pores, and prostaglandins should be administered instead of diuretics.
I. Bar, None.