Effect of Various Factors on Peritoneal Lymphatic Flow in Rabbits

1989 ◽  
Vol 9 (2) ◽  
pp. 85-90 ◽  
Author(s):  
Andrzej Breborowicz ◽  
Helen Rodela ◽  
D.G. Oreopoulos
Keyword(s):  
Peritoneal Dialysis ◽  
Protein Content ◽  
Flow Rate ◽  
Peritoneal Cavity ◽  
Lymphatic Drainage ◽  
Lymph Flow ◽  
Lymphatic Flow ◽  
Dialysate Volume ◽  
Normal Controls

Peritoneallymphatic flow in normal and uremic rabbits was measured by estimation of the disappearance of the radiolabelled 1311–albumin from the peritoneal cavity. The results show that lymph flow rate from the peritoneal cavity is not steady and depends on dialysate volume, its tonicity, and protein content. During peritoneal dialysis, peritoneal lymphatic flow is lower at the beginning of an exchange. Peritoneal lymphatic drainage is higher in uremic rabbits compared to normal controls.

scholarly journals Peritoneal Cavity Lymphatics

1986 ◽  
Vol 6 (3) ◽  
pp. 113-121 ◽  
Author(s):  
Ramesh Khanna ◽  
Robert Mactier ◽  
Zbylut J. Twardowski ◽  
Karl D. Nolph
Keyword(s):  
Connective Tissue ◽  
Gap Junctions ◽  
Flow Rate ◽  
Peritoneal Cavity ◽  
Layered Structure ◽  
Whole Blood ◽  
Lymphatic Drainage ◽  
Abdominal Pressure ◽  
Particulate Matters ◽  
Lymphatic Flow

Lymphatic drainage of particulate matters from the peritoneal cavity occurs mainly from lacunae located in the diaphragm. These are a triple-layered structure consisting of mesothelium, a loose network of connective tissue and endothelium. Absorption of particles may occur via gap junctions, through the cells or via vesicles. Whole blood can be removed fairly rapidly from the peritoneal cavity. Respiration plays an important role in the absorption of particles through lymphatics. Intra-abdominal pressure and posture are other factors which influence lymphatic flow rate in the peritoneal cavity. Little is known about the influence of drugs on lymphatic flow rate from the peritoneal cavity.

Peritoneal lymphatic uptake of fibrinogen and erythrocytes in the rat

1983 ◽  
Vol 244 (1) ◽  
pp. H89-H96 ◽  
Author(s):  
M. F. Flessner ◽  
R. J. Parker ◽  
S. M. Sieber
Keyword(s):  
Flow Rate ◽  
Peritoneal Cavity ◽  
Thoracic Duct ◽  
Significant Proportion ◽  
Lymphatic Drainage ◽  
Lymph Flow ◽  
Lymphatic Transport ◽  
Fluid Loss ◽  
Intraperitoneal Pressure ◽  
Large Molecular Weight

Intact and thoracic duct-cannulated rats were dialyzed at various intraperitoneal pressures with 5% bovine serum albumin solutions containing 125I-fibrinogen or 51Cr-erythrocytes. Lymphatic transport rates were calculated from the mass of tracer passing into the plasma space as function of tracer concentration in the peritoneal fluid during dialysis periods ranging between 143 and 360 min. Peritoneal protein concentrations were constant over the duration of the experiments. The calculated lymph flow rate was independent of intraperitoneal pressure and in intact rats averaged 2.85 +/- 1.22 microliters/min for uptake of 125I-fibrinogen and 2.60 +/- 1.17 for uptake of 51Cr-erythrocytes. However, the observed fluid loss rates from the peritoneal cavity were sensitive to the intraperitoneal pressure and were 5 to 20 times the calculated lymph flow rate. Mass balance experiments in two rats dialyzed with 125I-fibrinogen indicated that a significant proportion (28%) of tracer leaving the peritoneal cavity is absorbed by the anterior muscle wall of the abdomen and is probably trapped there because of its large molecular weight. Results from 125I-fibrinogen and 51Cr-erythrocyte uptake experiments both indicated that only approximately 30% of the total lymphatic drainage of the peritoneal cavity passes through the thoracic duct in rats.

Lymph flow in sheep with rapid cardiac ventricular pacing

1997 ◽  
Vol 272 (5) ◽  
pp. R1595-R1598 ◽  
Author(s):  
R. E. Drake ◽  
S. Dhother ◽  
R. A. Teague ◽  
J. C. Gabel
Keyword(s):  
Heart Failure ◽  
Flow Rate ◽  
Mediastinal Lymph Node ◽  
Venous Pressure ◽  
Lymphatic Vessels ◽  
Lymph Flow ◽  
Ventricular Pacing ◽  
Fluid Filtration ◽  
Flow Rates ◽  
Lymphatic Flow

Increases in systemic venous pressure (Pv) associated with heart failure cause an increase in microvascular fluid filtration into the tissue spaces. By removing this excess filtrate from the tissues, lymphatic vessels help to prevent edema. However, the lymphatics drain into systemic veins and an increase in Pv may interfere with lymphatic flow. To test this, we cannulated caudal mediastinal node efferent lymphatics in sheep. We used rapid cardiac ventricular pacing (240-275 beats/min) to cause heart failure for 4-7 days. Each day we determined the lymph flow rate two ways. First, we adjusted the lymph cannula height so that the pressure at the outflow end of the lymphatic was zero. After we determined the lymph flow with zero outflow pressure, we raised the cannula so that outflow pressure was equal to the actual venous pressure. We quantitated the effect of venous pressure on lymph flow rate by comparing the flow rate with outflow pressure = Pv to the flow rate with zero out low pressure. At baseline, Pv = 5.0 +/- 2.5 (SD) cmH2O and we found no difference in the two lymph flow rates. Pacing caused Pv and both lymph flow rates to increase significantly. However for Pv < 15 cmH2O, we found little difference in the two lymph flow rates. Thus increases in Pv to 15 cmH2O at the outflow to the lymphatics had little effect on lymph flow. By comparison, Pv > 15 cmH2O slowed lymph flow by 55 +/- 29% relative to the lymph flow rate with zero outflow pressure. Thus Pv values > 15 cmH2O interfere with lymph flow from the sheep caudal mediastinal lymph node.

Effect of outflow pressure on liver lymph flow in unanesthetized sheep

1990 ◽  
Vol 259 (4) ◽  
pp. R780-R785 ◽  
Author(s):  
R. E. Drake ◽  
J. C. Gabel
Keyword(s):  
Hepatic Vein ◽  
Flow Rate ◽  
Lymphatic Vessel ◽  
Venous Pressure ◽  
Lymph Flow ◽  
Reference Level ◽  
Effective Pressure ◽  
Lymphatic Flow ◽  
Zero Reference ◽  
Po Delta

We used lymph flow rate (QL) to lymphatic vessel outflow pressure (Po) relationships to analyze lymphatic flow in five unanesthetized sheep with liver lymphatic cannulas. The olecranon was the zero reference level for pressures. Increases in Po did not change QL until Po exceeded 19 +/- 4 (SD) cmH2O. However, for Po greater than 19 +/- 4 cmH2O, QL decreased linearly with increases in Po. We fit regression lines to the QL vs. Po data for Po greater than 19 cmH2O and estimated the effective lymphatic resistance (RL) as -delta Po/delta QL. The effective pressure driving lymph (PL) was the Po at which QL = 0. At baseline, RL = 0.18 +/- 0.10 cmH2O.min.microliter-1 and PL = 29.6 +/- 3.4 cmH2O. When we increased hepatic vein pressure by 5.7 +/- 1.7 cmH2O, QL increased to 6.2 +/- 3.2 times baseline, RL decreased to 0.050 +/- 0.015 cmH2O.min.microliter-1, and PL increased to 37.1 +/- 3.5 cmH2O (P less than 0.05). Thus 1) liver lymph flow is very sensitive to increases in hepatic vein pressure, 2) there is a substantial QL vs. Po plateau for liver lymphatics, and 3) after hepatic venous pressure elevations, liver lymph flow increases as if it were driven by a higher pressure through a lower resistance.

Quantitation of Lymphatic Drainage of the Peritoneal Cavity in Sheep: Comparison of Direct Cannulation Techniques with Indirect Methods to Estimate L Ymph Flow

1993 ◽  
Vol 13 (4) ◽  
pp. 270-279 ◽  
Author(s):  
Lisa Tran ◽  
Helen Rodela ◽  
John B. Hay ◽  
Dimitrios Oreopoulos ◽  
Miles G. Johnston
Keyword(s):  
Peritoneal Cavity ◽  
Lymphatic Drainage ◽  
Lymph Flow ◽  
Lymph Drainage ◽  
Flow Rates ◽  
Drainage Fluid ◽  
Peritoneal Drainage ◽  
Ultrafiltration Failure ◽  
Lymph Duct ◽  
The Right

Objective It has been suggested that lymphatics may contribute to ultrafiltration failure in patients on continuous ambulatory peritoneal dialysis (CAPD) byabsorbing dialysate and ultrafiltrate from the peritoneal cavity. In most studies lymphatic drainage has been estimated from the disappearance of an instilled tracer from the peritoneal cavity or estimated from the appearance of an intraperitoneally administered tracer in the bloodstream. However, in sheep it is possible to cannulate several of the relevant lymphatics that drain the peritoneal cavity and assess lymph drainage parameters directly. The purpose of this study was to estimate lymph drainage from the peritoneal cavity in sheep using the disappearance of tracer from the cavity and the appearance of intraperitoneally instilled tracer in the bloodstream and to compare these results with those obtained from our previous studies using cannulation techniques. Design Experiments were performed in anesthetized and nonanesthetized animals. Volumes of 50 mL/kg of Dianeal 4.25% containing 25 μCi of 1251-albumin were infused into the peritoneal cavity. Results In anesthetized sheep the calculated peritoneal lymph drainage from monitoring the disappearance of tracer from the peritoneal cavity over 6 hours was 1.873±0.364 mL/kg/hour. Monitoring the appearance of tracer in the blood gave significantly lower peritoneal lymph flow rates of 1.094±0.241 mL/kg/hour. Directly measured lymph flow rates from our earlier publication were lower still and ranged from 0.156±0.028 -0.265±0.049 mL/hour/kg, depending on how we estimated the right lymph duct contribution to peritoneal drainage, since we could not cannulate this vessel. We repeated these experiments in conscious sheep. The value for lymph flow estimated from the disappearance of tracer from the peritoneal cavity was 2.398±0.617 mL/hour/kg and from the appearance of tracer in the blood, 1.424±0.113 mL/ hour/kg. The1ymph flow rates monitored from indwelling lymphatic catheters ranged from 1.021 ±0.186 -1.523±0.213 mL/hour/kg (again, depending on our estimates for the right lymph duct). Conclusions Lymph flow rates measured from indwelling lymphatic catheters provided the most conservative values for lymphatic drainage of the peritoneal cavity under dialysis conditions. Estimates of lymphatic drainage based on the appearance of tracer in the blood gave values that were on average higher. The method using the disappearance of tracer from the cavity to estimate lymph flows overestimated peritoneal lymph drainage. Fluid was lost from the peritoneal cavity, and the estimated proportion of liquid lost through lymphatic drainage depended on the technique used to measure lymph flow rates.

Indirect Measurement of Lymphatic Absorption with Inulin in Continuous Ambulatory Peritoneal Dialysis (CAPD) Patients

1990 ◽  
Vol 10 (2) ◽  
pp. 141-145 ◽  
Author(s):  
Dirk G. Struijk ◽  
Raymond T. Krediet ◽  
Gerardus C. M. Koomen ◽  
Elisabeth W. Boeschoten ◽  
Hendrik J. Vd Reijden ◽  
...  
Keyword(s):  
Mass Transfer ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Lymphatic Drainage ◽  
Indirect Measurement ◽  
Lymphatic Absorption ◽  
Lymphatic Flow ◽  
Peritoneal Tissue ◽  
The Difference ◽  
Local Accumulation

To elucidate the importance of possible trapping of macromolecules in peritoneal tissue on the calculation of peritoneal lymphatic drainage, we compared the transport of inulin administered i.v. and i.p. in nine continuous ambulatory peritoneal dialysis (CAPD) patients on two separate days. In the intraperitoneal study inulin (5 g) was added to the dialysate and in the intravenous study inulin (5 g) was given i.v. 3 h before the test. No differences were found in the mass transfer area coefficients (MTC) of urea, creatinine, and glucose between the two tests. The MTC after inulin i.p. was 3.2 ± 0.7 mLlmin (mean ± SD) and after inulin i.v. 1.8 ± 0.5 (p < 10-5). As the difference in transport kinetics between i.v. and i.p. administration is likely to be caused by lymphatic absorption, a mean lymphatic flow of 1.4 mLlmin could be calculated. This value corresponds to the data obtained with macromolecules. Our results therefore favor the hypothesis that no local accumulation of macromolecules in the peritoneal tissues takes place and that their disappearance from the peritoneal cavity represents lymphatic absorption.

Reduced Lymphatic Drainage of Dialysate from the Peritoneal Cavity during Acute Peritonitis in Sheep

1996 ◽  
Vol 16 (2) ◽  
pp. 163-171 ◽  
Author(s):  
Helen Rodela ◽  
Zheng-Yi Yuan ◽  
John B. Hay ◽  
Dimitrios G. Oreopoulos ◽  
Miles G. Johnston
Keyword(s):  
Peritoneal Cavity ◽  
Thoracic Duct ◽  
Mediastinal Lymph Node ◽  
Lymphatic Drainage ◽  
Lymph Flow ◽  
Lymph Drainage ◽  
Total Recovery ◽  
Acute Peritonitis ◽  
Conscious Sheep ◽  
The Right

Objectives The purpose of this study was to investigate the effects of acute peritonitis on lymphatic drainage of the peritoneal cavity in conscious sheep Design Peritonitis was induced with the addition of 1% casein or 1% albumin to the dialysis solution. Thirty sheep (5 groups of 6) were used in this study. One group received 50 mL/kg intraperitoneal infusions of Dianeal 4.25% (486 mOsm/L); a second group received 1% casein-DianeaI4.25% (493 mOsm/L); a third group received 1% albumin-Dianeal 4.25% (487 mOsm/L). In the fourth and fifth groups (controls and casein-injected) lymph was collected from the caudal mediastinal lymph node and the thoracic duct, both of which are involved in the lymphatic drainage of the peritoneal cavity (peritonitis induced with casein). 1251-human serum albumin (25 μCi) was added to the dialysate as the lymph flow marker. Lymph drainage was estimated from (1) the appearance of the intraperitoneally administered tracer in the blood; (2) the disappearance of the tracer from the peritoneal cavity; and (3) the recovery of tracer in lymph. Results In noncannulated animals the cumulative volume removed by lymphatics over 6 hours (based on tracer recovery in blood) was 10.5 ±1.0 mL/kg in control animals versus 5.0 ± 0.6 mL/kg and 8.6 ± 1.2 mL/kg in casein and albumin-infused sheep, respectively. The suggestion of decreased lymph drainage in peritonitis was supported by the cannulation experiments. While the cumulative fluid removed from the peritoneal cavity over 6 hours in caudal lymph was unaffected by peritonitis (3.8 ± 0.4 mL/kg in controls vs 3.6 ± 0.5 mL/kg in casein injected animals), peritonitis reduced flow into the thoracic duct from 3.0 ± 0.3 to 1.1 ± 0.3 mL/kg. The sum of the volume removed in lymph in the cannulated preparations was 6.8 ± 0.4 mL/kg in controls versus 4.7 ± 0.5 mL/kg in the peritonitis group. The total volume removed from the cavity (including an estimate of flow based on the residual recovery of tracer in blood) was reduced from 12.6 ±1.4 in controls to 7.8 ± 0.6 mL/kg in the peritonitis sheep. In contrast, estimates of lymph drainage based on the disappearance of tracer from the peritoneal cavity suggested that lymph drainage increased (from 16.6 ±1.6 mL/kg in controls to 17.8 ±1.5 mL/kg and 25.5 ±1.7 mL/kg in the casein and albumin groups, respectively, in noncannulated animals and from 15.3 ± 1.4 mL/kg in controls to 25.0 ± 1.7 mL/kg in the cannulated group). In both noncannulated and cannulated sheep the total recovery of tracer was less in the peritonitis groups. Conclusions These studies demonstrated that lymph drainage of the peritoneal space was decreased in a casein peritonitis model. The decrease in lymph drainage is most obvious in the visceral pathway leading to the thoracic duct; however, diaphragmatic drainage into the right lymph duct may also be inhibited. The disappearance of tracer from the peritoneal cavity was elevated during peritonitis. Tracer disappearance has been used to estimate lymph drainage, but this approach suggested, incorrectly, that lymph flow had increased.

scholarly journals Effects of physical therapy on hyaluronan clearance and volume regulating hormones in lower limb lymphedema patients: A pilot study

2021 ◽  
Vol 104 (1) ◽  
pp. 003685042199848
Author(s):  
Bianca Brix ◽  
Gert Apich ◽  
Andreas Rössler ◽  
Sebastian Walbrodt ◽  
Nandu Goswami
Keyword(s):  
Pilot Study ◽  
Lower Limb ◽  
Time Course ◽  
Plasma Renin ◽  
Lymphatic Drainage ◽  
Invasive Treatment ◽  
Lymphatic Flow ◽  
Compression Bandaging ◽  
Complete Decongestive Therapy ◽  
Total Plasma Protein

Lymphedema is manifested as a chronic swelling arising due to stasis in the lymphatic flow. No cure is currently available. A non-invasive treatment is a 3 week complete decongestive therapy (CDT), including manual lymphatic drainage and compression bandaging to control swelling. As CDT leads to mobilization of several liters of fluid, effects of CDT on hyaluronan clearance (maker for lymphatic outflow), volume regulating hormones, total plasma protein as well as plasma density, osmolality and selected electrolytes were investigated. In this pilot study, we assessed hyaluronan and volume regulating hormone responses from plasma samples of nine patients (three males, six females, aged 55 ± 13 years) with lower limb lymphedema stage II-III, before - and after - CDT. A paired non-parametric test (Wilcoxon) was used to assess hormonal and plasma volume changes. Correlation was tested using Spearman’s correlation. The main findings of this novel study are that lymphedema patients lost volume and weight after therapy. Hyaluronic acid did not significantly change pre- compared to post-CDT. Aldosterone increased significantly after therapy, while plasma renin activity increased, but not significantly. Plasma total protein, density, osmolality and sodium and chloride did not show differences after CDT. To our knowledge, no study has previously investigated the effects of CDT on volume regulating hormones or electrolytes. To identify the time-course of volume regulating hormones and lymphatic flow changes induced by CDT, future studies should assess these parameters serially over 3 weeks of therapy.

Effect of PEEP on the rate of thoracic duct lymph flow and clearance of bacteria from the peritoneal cavity

1983 ◽  
Vol 145 (1) ◽  
pp. 126-130 ◽  
Author(s):  
Michael Last ◽  
Lewis Kurtz ◽  
Theodore A. Stein ◽  
Leslie Wise
Keyword(s):  
Peritoneal Cavity ◽  
Thoracic Duct ◽  
Lymph Flow ◽  
Thoracic Duct Lymph ◽  
Duct Lymph

Klebsiella pneumoniae Renal Abscess and Peritonitis in a Peritoneal Dialysis Patient: A Novel Route of Infection

2017 ◽  
Vol 37 (6) ◽  
pp. 654-656
Author(s):  
Miten J. Dhruve ◽  
Joanne M. Bargman
Keyword(s):  
Peritoneal Dialysis ◽  
Klebsiella Pneumoniae ◽  
Renal Biopsy ◽  
Peritoneal Cavity ◽  
Successful Treatment ◽  
Dialysis Patient ◽  
Peritoneal Dialysis Patient ◽  
Renal Abscess ◽  
Biopsy Site ◽  
Route Of Infection

We present a peritoneal dialysis (PD) patient who had a renal biopsy performed during an episode of urosepsis and subsequently presented with a renal abscess at the biopsy site along with concurrent peritonitis. Microbiology from the PD effluent and from the renal abscess were both positive for Klebsiella pneumoniae. We propose that the PD peritonitis was the result of seeding of the peritoneal cavity with bacteria from the renal abscess. Successful treatment was achieved through drainage of the abscess and intraperitoneal antibiotics.

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