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Nephrology Unit, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York 14642
We and others have shown that the loss of
fluid and macromolecules from the peritoneal cavity is directly
dependent on intraperitoneal hydrostatic pressure
(Pip). Measurements of the
interstitial pressure gradient in the abdominal wall demonstrated
minimal change when Pip was
increased from 0 to 8 mmHg. Because flow through tissue is governed by
both interstitial pressure gradient and hydraulic conductivity
(K), we hypothesized that
K of these tissues varies with
Pip. To test this hypothesis, we
dialyzed rats with Krebs-Ringer solution at constant
Pip of 0.7, 1.5, 2.2, 3, 4.4, 6, or 8 mmHg. Tracer amounts of
125I-labeled immunoglobulin G were
added to the dialysis fluid as a marker of fluid movement into the
abdominal wall. Tracer deposition was corrected for adsorption to the
tissue surface and for local loss into lymphatics. The hydrostatic
pressure gradient in the wall was measured using a micropipette and a
servo-null system. The technique requires immobilization of the tissue
by a porous Plexiglas plate, and therefore a portion of the tissue is
supported. In agreement with previous results, fluid flux into the
unrestrained abdominal wall was directly related to the overall
hydrostatic pressure difference across the abdominal wall
(Pip = 0), but the interstitial
pressure gradient near the peritoneum increased only ~40% over the
range of Pip = 1.5-8 mmHg
(20-28 mmHg/cm). K of the
abdominal wall varied from 0.90 ± 0.1 × 10
5
cm2 · min
1 · mmHg
1
at Pip = 1.5 mmHg to 4.7 ± 0.43 ×10
5
cm2 · min
1 · mmHg
1
on elevation of Pip to 8 mmHg. In
contrast, for the same change in
Pip, abdominal muscle supported on
the skin side had a significantly lower range of fluid flux
(0.89-1.7 × 10
4
vs. 1.9-10.1 × 10
4
ml · min
1 · cm
2
in unsupported tissue). The differences between supported and unsupported tissues are likely explained in part by a reduced pressure
gradient across the supported tissue. In conclusion, the in vivo
hydraulic conductivity of the unsupported abdominal wall muscle in
anesthetized rats varies with the superimposed hydrostatic pressure
within the peritoneal cavity.
interstitium; convection; transport; solvent drag; peritoneal cavity
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