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Capillary Leak Syndrome With Pulmonary Edema
Eugene D. Robin, MD;
Larry C. Carey, MD;
Ake Grenvik, MD;
Frederick Glauser, MD;
Ralph Gaudio, MD
Arch Intern Med. 1972;130(1):66-71.
Abstract
In two patients with a diffuse abnormality of capillary permeability possibly related to circulating endotoxin, loss of plasma into the tissues (capillary leak syndrome) produced hypovolemic shock, generalized edema, hemoconcentration, and florid pulmonary edema. Pulmonary edema fluid (PEF) was collected and its chemical composition compared to plasma. A number of solutes including the various plasma proteins were in near chemical equilibrium between plasma and PEF. Intravenous administration of dextran 70 (molecular weight 70,000) and dextran (molecular weight 500,000) (in one patient), led to accumulation of these compounds in PEF at a rate consistent with abnormally high pulmonary capillary permeability. These cases document the development of pulmonary edema secondary to increased pulmonary capillary permeability. Possibly, a number of pulmonary diseases (collectively called adult respiratory distress syndrome) result from increased pulmonary capillary permeability, increased alveolar epithelial permeability, or abnormalities of pulmonary interstitial solute removal.
Author Affiliations
Stanford, Calif; Pittsburgh
From the departments of medicine (Dr. Robin), surgery (Dr. Carey), and anesthesiology (Dr. Grenvik), University of Pittsburgh School of Medicine (Drs. Glauser and Gaudio), Pittsburgh. Dr. Robin is now with the departments of medicine and physiology, Stanford University Medical Center, Stanford, Calif.
Footnotes
Received for publication Nov 16, 1970; accepted Oct 1, 1971.
Reprint requests to Department of Medicine, Stanford University School of Medicine, Stanford, Calif 94305 (Dr. Robin).
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