Diaphragmatic Lymph Vessel Drainage of the Peritoneal Cavity

Abstract

We have studied the drainage of peritoneal fluid through the diaphragmatic lymph vessels in sheep. To measure the lymphatic flow rate, we cannulated the lymphatic vessels and timed the flow from the cannula. After we infused Escherichia coli endotoxin into awake sheep, the diaphragmatic lymph flow rate increased substantially. However, we found no increase in lymph flow in anesthetized acutely operated sheep. This indicates that studies in anesthetized animals may yield underestimates of diaphragmatic lymph flow. In sheep, many of the diaphragmatic lymph vessels drain to the caudal mediastinal lymph node. We cannulated an efferent vessel from that node in 5 sheep. Several days later we infused 100 ml/kg of Ringer’s solution into the abdominal space of each awake sheep. In response, the lymph flow rate increased from 0.15 ± 0.16 ml/min (mean ± SD) to 0.50 ± 0.17 ml/min. Our results are important because they demonstrate that diaphragmatic lymph flow increases substantially after fluid infusions into the abdominal space.

The Effective Lymphatic Absorption Rate is an Accurate and Useful Concept in the Physiology of Peritoneal Dialysis

“…Compared to 2 L, lower values are found with 1.5 L (12) and higher values with 3 L (18). These findings are in accordance with experimental data in sheep, where IP infusion of Ringer's solution caused a marked increase in directly measured flow from the caudal mediastinal lymph node (19).…”

Sodium Balance in Automated Peritoneal Dialysis

“…However, these effects are countered by the increase in intraperitoneal pressure caused by the large volume instilled. The pressure increase leads to increased reabsorption of fluid, partly by a higher lymphatic absorption rate (21,22) and partly by transmesothelial water transport (23,24). These mechanisms increase the absorption of sodium.…”

Pathophysiology of Peritoneal Membrane Failure

“…It increases the transcapillary UF rate (79,80) due to the longer persistence of the glucose gradient. However, the removal rate of fluid from the peritoneal cavity is also higher, due partly to increased lymphatic absorption (55,82) and partly to transmesothelial water transport (79,80). The effect on net UF is therefore dependent on the magnitude of these opposing pathways of peritoneal fluid transport.…”