Pulmonary extraction of 14 C-5-hydroxytryptamine and 3 H-norepinephrine was estimated in patients undergoing aortocoronary saphenous vein grafting. Identical mixtures of both amines were administered intravenously before cardiopulmonary bypass and again just after bypass. Immediately after each injection, 6 ml of blood was withdrawn into tubing, at a constant rate, simultaneously from both the pulmonary artery and the left atrium. Each set of tubing was then divided into six segments, and the 3 H and 14 C content of each segment was measured. In this manner, total isotope collected and blood isotope concentration as a function of time at the two sampling sites were compared directly. Before bypass in every patient studied, less 5-hydroxytryptamine and norepinephrine were withdrawn on the left than on the right of the lungs, implying pulmonary extraction of both amines. In nine patients, the mean percent extraction was 65 ± 4% for 5-hydroxytryptamine and 23 ± 5% for norepinephrine ( P < 0.005). After bypass, the percent extraction of both norepinephrine and 5-hydroxytryptamine was increased in all but one patient; values for norepinephrine were increased to a realtively greater extent. These data represent a direct demonstration of 5-hydroxytryptamine and norepinephrine extraction by human lungs and also suggest that total cardiopulmonary bypass may alter the process.KEY WORDS lung aortocoronary bypass pulmonary vascular space amine extraction• Both 5-hydroxytryptamine (5-HT) and norepinephrine (NE) are removed, to varying degrees, from the pulmonary vascular space of dog (1-4), cat (5), rat (6, 7), guinea pig (8), and rabbit (9). Pulmonary venous and, thus, systemic arterial blood concentrations of these amines are significantly decreased by passage through the lung. The mechanisms and possible physiological significance of the process are unknown, though it has been suggested (10) that pulmonary clearance prevents vasoactive substances (including both NE and 5-HT) which are present inFrom the