Extravascular lung water with special reference to thoracotomy, manual lung manipulation and rapid fluid transfusion.

An increase in extravascular lung water (EVLW) is indicative of pulmonary edema and the measurement of EVLW has been considered as an important clue for the early detection of pulmonary edema, which is a serious complication of lung surgery. The influence of thoracotomy, manual lung manipulation and rapid fluid transfusion on EVLW were experimentally studied in the lung tissue of dogs, using the double indicator dilution method and comparing it with the drying method. The following results were obtained. 1) EVLW measured by the double indicator dilution method correlated well with EVLW measured by the drying method of tissue at 80 degrees C for 48 hours. 2) EVLW was significantly increased immediately after rapid fluid transfusion. EVLW increased as the osmotic pressure in the transfused fluid became higher. 3) Even the simple procedure of thoracotomy resulted in an increase of EVLW and the addition of manual compression to the lung facilitated this increase of EVLW even further.