Changes of extravascular lung water after hepatic ischemia by Pringle's maneuver Part 1. In regard to the increase of the extravascular lunh water and its cause

To elucidate the effect of total hepatic ischemia on pulmonary organs, extravascular lung water (EVLW) was experimentally measured using a modified double indicator dilution method before and after interruption of the hepatic blood flow using Pringle's maneuver. The follow-ing results were obtained : 1) EVLW was significantlly increased more than one hour after temporary total hepatic ischemia. 2) Temporary hypotension resulted in little increase of EVLW by removing and replacing some blood volume through the femoral artery. 3) Pumonary interstitial edema was histologically and maroscopically observed in the Pringle's maneuver group. 4) Marked metabolic acidosis and elevation of serum transaminase were revealed after temporary hepatic ischemia. These findings auggest that pulmonary interstitial edema may result from sfter temporary total hepatic ischemia by Pringle's maneuver and the changes of EVLW are caused by increased permeability due to liver injury, metabolic acidosis and portal congestion.