J.Jpn. Surg. Soc.. 59(9): 1478-1492, 1958

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EXPERIMENTAL STUDIE ON PULMONARY EDEMA

Blood transfusion after sever hemorrhagic shock is one of the most important causes of acute pulmonary edema which is encountered during surgical procedures and this kind of edema shows no left heart insufficiency experimentally.
Electromyograms of each ventricle show lower waves in hemorrhagic shock, but in many cases, after subsequent blood transfusion, only right ventricular waves become higher. It seems that right heart hypertension and left heart hypotension are concerned with the preceding observation, because in that stage, pulmonary arterial pressures increase to over 25 cmH₂O, and pulmonary venous pressures almost equal to inicial value.
In this experiments, the decrease of plasma oncotic pressure, and the increased pulmonary capillary permiability without pulmonary hypertension are thought to be important.
In general, profound circulatory disturbance of the central nervous system may progress in hemorrhagic shock, this disturbance has an influence upon the pulmonary circulation via the sympathetic nervous system, resulting in an increase of the pulmonary pressure gradient, and this tendency may be amplified after transfusion, such mechanism was demonstrated.
And it was found that the evaluation of peripheral venous pressure which is correlative to pulmonary arterial pressure, offers a clue to the speed of transfusion, when it is needed.
(author's abstract)

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