Intrapulmonary irrigation

Abstract

In view of the limitations of the intravascular mode of therapy of respiratory conditions, as exemplified in pneumonia, a series of experiments has been conducted looking into the possibility of an intratracheal or intrapulmonary therapy for such conditions.

The data thus far secured demonstrates the fact, fundamental to any such therapeutic procedure, that the lung is much less susceptible to the introduction of fluid than has been generally assumed.

Normal dogs have been used throughout the work and all perfusions or irrigations have been made with normal salt solution. The fluid was introduced by the usual method of insufflation.

Repeated experiments have shown that the lungs can be entirely flooded with salt solution and the process of irrigation continued for at least two hours with the introduction of 30,000 c.c. of fluid without causing any evident harmful signs in bodily wellbeing or any subsequent serious microscopic lesions in the lung tissue.

By means of the use of colored solutions, such as India ink, it has been shown that even the last portions of the fluid introduced actually pass throughout the lung tissue and do not simply flow back through the trachea without entering the lung.

Such irrigation procedure is relatively effective in removing material from the lung. The preliminary insufflation of such materials as India ink, protargol, or starch paste, followed by irrigation with salt solution has shown that a large percentage of the indicator was removed by the perfusion. In the same way an irrigation of the lungs with 3,000 c.c. of salt solution following an insufflation of a heavy broth culture of B. prodigiosus removed 90 per cent. of the number of organisms introduced.

As a corollary to the above experiments a study was made of absorption from the lung.