Relationsip of pulmonary capillary protein flux to irreversible hypotension following hemorrhagic shock and reinfusion

Using the right thoracic duct (RTD) in dogs, the authors designed an experiment to answer the question, what are the protein kinetics across the pulmonary capillaries after hemorrhagic shock and reinfusion? The data suggest that following shock and reinfusion, the pulmonary capillaries of some dogs have a greatly increased leak of albumin and globulin with a consequent increased pulmonary lymph flow rate. This is associated with an inability to maintain the systemic blood pressure. Dogs which do not develop these changes are able to maintain a more normal mean systolic pressure. The reason Demling et al. were unable to demonstrate any increase in protein flux during hemorrhage shock might be that the increase in permeability was balanced by the low hydrostatic pressure and a decrease in the perfused capillary area.