Document Detail

Mechanisms controlling the volume of pleural fluid and extravascular lung water.
MedLine Citation:
PMID:  20956149     Owner:  NLM     Status:  MEDLINE    
Pleural and interstitial lung fluid volumes are strictly controlled and maintained at the minimum thanks to the ability of lymphatics to match the increase in filtration rate. In the pleural cavity, fluid accumulation is easily accommodated by retraction of lung and chest wall (high compliance of the pleural space); the increase of lymph flow per unit increase in pleural fluid volume is high due to the great extension of the parietal lymphatic. However, for the lung interstitium, the increase in lymph flow to match increased filtration does not need to be so great. In fact, increased filtration only causes a minor increase in extravascular water volume (<10%) due to a marked increase in interstitial pulmonary pressure (low compliance of the extracellular matrix) which, in turn, buffers further filtration. Accordingly, a less extended lymphatic network is needed. The efficiency of lymphatic control is achieved through a high lymphatic conductance in the pleural fluid and through a low interstitial compliance for the lung interstitium. Fluid volume in both compartments is so strictly controlled that it is difficult to detect initial deviations from the physiological state; thus, a great physiological advantage turns to be a disadvantage on a clinical basis as it prevents an early diagnosis of developing disease.
G Miserocchi
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  European respiratory review : an official journal of the European Respiratory Society     Volume:  18     ISSN:  1600-0617     ISO Abbreviation:  Eur Respir Rev     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2010-10-19     Completed Date:  2011-02-24     Revised Date:  2012-01-10    
Medline Journal Info:
Nlm Unique ID:  9111391     Medline TA:  Eur Respir Rev     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  244-52     Citation Subset:  IM    
Dipartimento di Medicina Sperimentale, Facolta` di Medicina e Chirurgia, Universita` di Milano-Bicocca, Via Cadore 48, Monza, Italy.
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MeSH Terms
Body Fluids / physiology*
Edema / physiopathology
Extravascular Lung Water / physiology*
Lung Diseases / physiopathology
Models, Theoretical
Pleural Effusion / physiopathology

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