POSTICTAL PULMONARY-EDEMA REQUIRES PULMONARY VASCULAR PRESSURE INCREASES

The pathogenesis of neurogenic pulmonary edema has been debated for ma ny years. Whether cardiogenic mechanisms and increased pulmonary vascu lar pressures are primary or even necessary for the production of pulm onary edema has been argued, We used postictal pulmonary edema to stud y this problem in a sheep model of neurogenic pulmonary edema with bic ucullin-induced status epilepticus. Seizure-induced increases in pulmo nary vascular pressures were averted with a reservoir system to mainta in left atrial pressure (LAP) and pulmonary artery pressure (PAP) at p reseizure levels. No increase in lung lymph flow occurred during seizu res, in contrast to the doubling of lung lymph flow that occurred duri ng seizures when ictal pulmonary vascular hypertension was not blocked . These data support a primary role of pulmonary vascular pressure inc reases in the production of neurogenic pulmonary edema.