ROBERT H. LISS AND JOHN C. NORMAN 
235 
tinuous fluid overloading may provide an ex- 
perimental system for a better understanding of 
iatrogenic clinical respiratory failure. 
SUMMARY 
Pathophysiologic assessment has been made 
of a canine model of fluid overload-induced 
acute respiratory insufficiency. 
Light microscopy and both transmission and 
scanning electron microscopy, and salient phys- 
iologic analyses, were performed on dogs fol- 
lov^ing fluid overloading. 
Only animals continually fluid overloaded 
(100 ml/kg/hr) showed clinical signs of pul- 
monary edema and died after 5-6 hours of in- 
fusion. Dogs which were controls, intermit- 
tently infused (50 ml/kg/hr, 25 minutes each 
hour for 6 hours) or continually infused (100 
ml/kg/hr for 5-6 hours) and treated with 
furosemide, exhibited no clinical signs of acute 
respiratory insufficiency and survived. 
The pathophysiologic observations and the 
associated canine model of acute respiratory in- 
sufficiency induced by continuous fluid overload- 
ing may provide an experimental system for a 
better understanding of iatrogenic clinical res- 
piratory failure. 
REFERENCES 
1. Berman, H. J. and Fulton, G. P. The microcircu- 
lation as related to shock. In Shock and Hyperten- 
sion, 12th Hahnemann Symposium. 
2. Blaisdell, F. W., Lim, R. C. and Stallone, R. J. 
The mechanism of pulmonary damage following 
shock. Surgery, 130:15, 1970. 
3. Daniel, R. A. and Cote, W. R. "Wet Lung," an 
experimental study. The effects of trauma and 
hypoxia. Ann. Surg. 127:836, 1948. 
4. Pomeranz, M. and Roseman, B. J. Experimental 
shock lung model. J. Trauma, 8:782, 1968. 
5. Wilson, J. W., Ratliff, N. B. and Hackel, D. B. 
The lung in hemorrhagic shock. Amer. J. Path. 
58(2) :337, 1970. 
6. Coalsen, J. J., HiNSHAW, L. B. and Guenter, C. A. 
The pulmonary ultrastructure in septic shock. Exp. 
Molecular Path. 12:84, 1970. 
7. AsHBAUGH, D. G. and Vzawa, T. Respiratory and 
Hemodynamic Changes After Injection of Free 
Fatty Acids. J. Surg. Res. 84:417, 1968. 
8. Veith, F. J., Hagstrom, J. W., Panossian, A., 
Nehisen, S. L., and Wilson, J. W. Pulmonary 
microcirculatory response to shock, transfusion and 
pump-oxygenator procedures : a unified mechanism 
underlying pulmonary damage. Surgery, 64:95, 
1968. 
9. Altschule, M. D. Acute Pulmonary Edema. Mod- 
ern Medical Monographs. Grune and Stratton, New 
York, 1954. 
10. Paine, R., Howard, F. A., Butcher, N. R. and 
Smith, J. R. Observations on pulmonary lymph 
flow and edema. Fed. Proc. 8:123, 1949. 
11. Smith, J. R. Observations on Experimental Pul- 
monary Edema. J. Clin. Investigation, 28:802, 1949. 
12. Butcher, H. R., Smith, J. R., and Howard, F. A. 
Observations on the role of . pulmonary congestion 
in the production of edema of the lungs. J. Lab. & 
Clin. Med. 36:288, 1950. 
13. Molokhia, F. a., Robinson, W. J., Martin, J. E., 
Liss, R. H., Ballantine, T. V. N. and Norman, 
J. C. Canine models of acute respiratory insuffi- 
ciency (ARI) with fluid overload. Clin. Res., 19(4) : 
741, 1971. 
14. Teplitz, C. The ultrastructural basis for pulmonary 
pathophysiology following trauma. J. Trauma, 8: 
700, 1968. 
15. Thal, a. p. Shock, A Physiologic Basis for Treat- 
ment. Yearbook Publishers, Chicago, 1971. 
16. Daly, B. D. T. and McNary, W. F. Type II (gran- 
ular alveolar) penumocyte in ultrastructural anal- 
ysis of stressed human lung. Surgical Forum, 27: 
38, (1971). 
17. McNary, W. F. and Berger, R. L. Ultrastructure 
of pulmonary edema in man. J. Clinical Res. 19(4) : 
509, 1971. 
18. NowELL, J. A. and Tyler, W. S. Scanning electron 
microscopy of the surface morphology of mamma- 
lian lungs. Amer. Rev. Resp. Dis. 103 : 313, 1971. 
19. Freeman, J. and Nunn, J. Ventilation-perfusion 
relationships after hemorrhage. Clin. Sci., 24:135 
1963. 
