Disorders of the lymph circulation: their relevance to anaesthesia and intensive care

Abstract

The lymphatic system is known to perform three major functions in the body: drainage of excess interstitial fluid and proteins back to the systemic circulation; regulation of immune responses by both cellular and humoral mechanisms; and absorption of lipids from the intestine. Lymphatic disorders are seen following malignancy, congenital malformations, thoracic and abdominal surgery, trauma, and infectious diseases. They can occasionally cause mortality, and frequently morbidity and cosmetic disfiguration. Many lymphatic disorders are encountered in the operating theatre and critical care settings. Disorders of the lymphatic circulation relevant to anaesthesia and intensive care medicine are discussed in this review.

Lymphatic Vascular Regeneration: The Next Step in Tissue Engineering

“…During inflammation, the lymphatics play an important role in drainage of cytokines and chemokines. For the regulation of uptak e of dietary lipids in 6 6 Edema, defined by the accumulation of extracellular fluid due to perturbations in the homeostasis between filtration out of the vascular space and return of fluid by lymphatics from the interstitial space, is one of the most prevalent symptoms associated with lymphatic dysfunction [17], [18]. Although the lymphatic system is involved in all manifestations of edema, only lymphedema is caused by disruption of lymphatic function such as for example due to capillary hypoplasia [16], [19].…”

“…The lymph fluid is propelled downstream by serial SMC contractions that force the flow from one lymphangion into the next [1]. The collecting vessels eventually come together in large sized lymphatic ducts that end in the subclavian vein where the fluids are drained into the bloodstream [18]. This tree-like structure of the lymphatic vasculature with distinct organization ranging from capillaries to large sized vessels is comparable to the venous vasculature that sustains a very similar hierarchy of small capillaries, collecting venules and veins, see Figure 1.…”

Physiology of the Airway

“…Instead, lymphatic capillaries first appear in the interstitial space surrounding terminal bronchioles, small arteries, and veins. 105 The opposite side of the alveolar septum (the thin, down, gas-exchanging-only side) contains only fused epithelial and endothelial basement membranes. The interstitial space is greatly restricted on this side because of fusion of the basement membranes.…”

Imaging of the lymphatic system: new horizons

“…Other mycobacterial infections are more commonly found in immunocompromised patients, and include Mycobacterium avium-intracellulare and Mycobacterium scroful-aceum. With these infections, onset of adenopathy is often rapid; the nodes may become tender and erythematous, requiring excision (7). Zoonoses are rare forms of infection.…”