Surfactant composition reflects lung overinflation and arterial oxygenation in patients with acute lung injury
| Autor: | Ian R. Doyle, HA Barr, Andrew D. Bersten, Terence Evan Nicholas, Kate G. Davidson, F Kermeen |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Heart Diseases Lung Overinflation Lung injury Pulmonary surfactant Internal medicine Intubation Intratracheal medicine Humans Lung volumes Respiratory Distress Syndrome Blood-Air Barrier Lung medicine.diagnostic_test Respiratory distress business.industry Respiratory disease Pulmonary Surfactants respiratory system medicine.disease respiratory tract diseases Oxygen Bronchoalveolar lavage medicine.anatomical_structure Case-Control Studies Anesthesia Respiratory Mechanics Cardiology business Bronchoalveolar Lavage Fluid |
| Zdroj: | European Respiratory Journal. 12:301-308 |
| ISSN: | 1399-3003 0903-1936 |
| DOI: | 10.1183/09031936.98.12020301 |
| Popis: | Pulmonary surfactant abnormalities have consistently been documented in patients with acute lung injury (ALI), however, there is little evidence directly correlating them to altered respiratory mechanics. To explore this further, surfactant composition was measured in lung aspirate fluid collected on 15 occasions from 10 patients with ALI. The composition was compared with lung aspirate fluid from 11 intubated patients prior to elective cardiac surgery (CS), and bronchoalveolar lavage fluid from 16 normal subjects. In both the ALI and cardiac groups the proportion of disaturated phospholipids (DSP) and phosphatidylcholine was reduced. Plasma levels of surfactant proteins-A and -B (SP-A and -B) were elevated, but were unrelated to alveolar surfactant levels. In the ALI group, and the ALI + CS group, DSP, normalized to the total phospholipid content, sphingomyelin (SPH), and urea, showed strong direct correlations with arterial oxygen tension/inspiratory oxygen fraction (all p < or = 0.01). In the ALI group, normalized DSP was also directly related to the elastance of the positive end-expiratory pressure-induced increase in the end-expiratory lung volume (all p < or = 0.02), and indirect correlations were found with a measure of lung overinflation (%E2; all p < or = 0.01). We conclude that surfactant composition correlates with lung function abnormalities in acute lung injury and cardiac patients, and that both groups had elevated plasma surfactant proteins-A and -B levels, consistent with a concurrent increase in alveolocapillary permeability. |
| Databáze: | OpenAIRE |
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