The Pattern of Early Lung Parenchymal and Air Space Injury Following Acute Blood Loss
| Autor: | Gerd O. Till, Peter F. Jost, Susan A. Stern, John G. Younger, Kent J. Johnson, Ronald B. Hirschl, Ali S. Taqi |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Lung Diseases
Male Resuscitation Pathology medicine.medical_specialty Neutrophils Shock Hemorrhagic Lung injury Rats Sprague-Dawley Leukocyte Count Interstitial space Parenchyma medicine Animals Prospective Studies Inflammation Blood-Air Barrier Lung medicine.diagnostic_test business.industry Blood–air barrier General Medicine respiratory system Extravasation Rats medicine.anatomical_structure Bronchoalveolar lavage Emergency Medicine business Bronchoalveolar Lavage Fluid |
| Zdroj: | Academic Emergency Medicine. 5:659-665 |
| ISSN: | 1553-2712 1069-6563 |
| DOI: | 10.1111/j.1553-2712.1998.tb02482.x |
| Popis: | UNLABELLED Acute lung injury is a frequent clinical occurrence following blood loss and trauma. The nature of this injury remains poorly understood. OBJECTIVE To examine the relative parenchymal and intra-alveolar distribution of inflammation in a rat model of hemorrhage and resuscitation. METHODS Rats were anesthetized and subjected to hemorrhage followed by resuscitation with shed blood and saline. Myeloperoxidase activity of lung homogenates and cytology of bronchoalveolar lavage fluid were used to measure total lung and intra-alveolar neutrophil invasion. Extravasation of i.v.-administered [125I]-albumin was used to determine total lung and alveolar permeability. Permeability results were analyzed using their base-10 logarithmic transformations. RESULTS 86 animals were studied. Whole-lung myeloperoxidase activity was increased (control = 0.34 +/- 0.16 units, injured = 0.84 +/- 0.43 units, p < 0.01), while there was no difference in intra-alveolar leukocyte counts (injured = 1.85 +/- 1.30 x 10(5)/mL, control = 2.44 +/- 1.75 x 10(5)/mL, p = 0.40), suggesting that the cellular component of the injury was more severe in the intravascular and interstitial spaces. There was a strong trend toward increased permeability in the interstitial compartment, and a significant increase in permeability in the intra-alveolar compartment (whole-lung permeability: control = -0.27 +/- 0.19 units, injured = 0.10 +/- 0.55 units, p = 0.06; alveolar permeability: control = -2.00 +/- 0.47 units, injured = -1.32 +/- 0.49 units, p < 0.01), suggesting that the loss of integrity to macromolecules was not limited to the interstitium. CONCLUSION Hemorrhage and resuscitation resulted in an acute lung injury characterized by extravasation of intravascular protein into both the interstitium and the intra-alveolar space. Neutrophil invasion of the lung was demonstrable only in the interstitial compartment. |
| Databáze: | OpenAIRE |
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