HYSKON(R)-INDUCED PULMONARY-EDEMA

Hyskon(R) (32 percent dextran-70) (Hyskon Division, Pharmacia) is used during hysteroscopy to help visualization of the uterine surfaces. Pu lmonary edema of an uncertain cause has occurred in many patients. Bec ause this study could not be conducted in humans, we determined if Hys kon caused cardiogenic or noncardiogenic pulmonary edema in a dog mode l. Dogs were randomly assigned to receive an infusion of Hyskon or who le blood to sustain left ventricular end-diastolic pressure between 20 and 23 millimeters of mercury for 60 minutes. In dogs receiving blood , there was no protein in the bronchoalveolar lavage before or after b lood was given. In the Hyskon group, there was no protein in the bronc hoalveolar lavage before Hyskon and 0.6 +/- 1.4 milligrams per decilit er (range of 0.1 to 3.7 milligram per deciliter) after Hyskon. The rat io of bronchoalveolar lavage protein to plasma protein after Hyskon wa s 8.0 +/- 18.0 percent compared with zero percent in the blood group. Hyskon altered pulmonary microvascular membrane permeability, causing alveolar flooding with plasma proteins and possibly accounting for the deterioration of oxygenation and pulmonary compliance seen in patient s. These results suggest a significant noncardiogenic component of Hys kon induced pulmonary edema.