Comparison of sodium and urea as indicators of pulmonary vascular permeability.

The objective of this work was to compare the blood-tissue transport properties of 14C-urea and 24Na in the lung circulation. The extraction of both substances was measured relative to intravascular reference tracers (125I-albumin for 24Na, 51Cr red cells and 125I-albumin for 14C-urea) in single-pass transpulmonary multiple indicator curves measured in awake sheep. Sheep were studied in baseline condition, after infusion of histamine solution (4 micrograms/kg-min for 4 hr), and after microvascular pressure was elevated. Permeability-surface area was computed for both sodium (PSn) and urea (PSu) by the Crone extraction model and by a mathematical model. In spite of the fact that the free diffusion coefficients of sodium and urea are approximately equal, the mean ratio of Crone PSn/PSu for baseline studies was 0.76. PSu was significantly increased by histamine infusion but PSn was not. The variation in PSn with histamine and increased pressure was marked. Thus, neither manipulation altered the ratio PSn/PSu in a consistent fashion. Correction of PS for extravascular distribution volumes of urea and Na did not change the PS ratio significantly. We concluded that the diffusional resistance to sodium is higher than expected from its diffusivity, possibly because of charge, and that PS for urea is more sensitive to changes in lung vascular permeability.