| Prognostic value of surfactant proteins A and D in patients with acute lung injury. | |
| | |
MedLine Citation:
|
PMID: 12544988 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: The primary objective of this study was to test the hypothesis that in patients intubated for acute lung injury, lower concentrations of surfactant proteins A and D in the pulmonary edema fluid and higher concentrations in the plasma are associated with more severe lung injury and worse clinical outcomes. DESIGN: Observational study. SETTING: Intensive care unit patients in a tertiary university hospital and a university-affiliated city hospital. PATIENTS: Thirty-eight intubated, mechanically ventilated intensive care unit patients with acute lung injury or acute respiratory distress syndrome as defined by the North American European Consensus Conference. INTERVENTIONS: Undiluted pulmonary edema fluid and plasma samples were collected within 24 hrs of endotracheal intubation in all patients. MEASUREMENTS AND MAIN RESULTS: The concentrations of surfactant proteins A and D were measured in pulmonary edema fluid and in plasma. Plasma surfactant protein A, but not surfactant protein D, was higher in patients with fewer days of unassisted ventilation (p = .03) and in patients with an absence of intact alveolar fluid clearance (p =.03). In contrast, pulmonary edema fluid surfactant protein D, but not surfactant protein A, was lower in patients with worse oxygenation, as measured by the alveolar-arterial oxygen difference (p = .01) and was lower in the patients who died (2646 ng/mL) compared with those who survived (5503 ng/mL; p = .02). CONCLUSIONS: These results demonstrate that reduced pulmonary edema fluid surfactant protein D and elevated plasma surfactant protein A concentrations at the onset of acute lung injury may be associated with more severe disease and worse clinical outcome and may serve as valuable biochemical markers of prognosis. |
| | |
Authors:
|
Ivan W Cheng; Lorraine B Ware; Kelly E Greene; Thomas J Nuckton; Mark D Eisner; Michael A Matthay |
Related Documents
:
|
16210888 - Cell profiles of bronchoalveolar lavage fluid as prognosticators of idiopathic pulmonar... 3183748 - Detection and treatment of lung metastases of differentiated thyroid carcinoma in patie... 2927158 - Does open lung biopsy affect treatment in patients with diffuse pulmonary infiltrates? 23173868 - Rumination variations: aetiology and classification of abnormal behavioural responses t... 15135458 - Anemia in the critically ill. 2068308 - Autourethrography. |
Publication Detail:
|
Type: Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
|
Title: Critical care medicine Volume: 31 ISSN: 0090-3493 ISO Abbreviation: Crit. Care Med. Publication Date: 2003 Jan |
Date Detail:
|
Created Date: 2003-01-24 Completed Date: 2003-02-14 Revised Date: 2007-11-14 |
Medline Journal Info:
|
Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States |
Other Details:
|
Languages: eng Pagination: 20-7 Citation Subset: AIM; IM |
Affiliation:
|
Cardiovascular Research Institute and Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Biological Markers Female Humans Male Prognosis Pulmonary Edema / metabolism Pulmonary Surfactant-Associated Protein A / blood, metabolism* Pulmonary Surfactant-Associated Protein D / blood, metabolism* Respiratory Distress Syndrome, Adult / diagnosis*, metabolism Statistics, Nonparametric |
| Grant Support | |
ID/Acronym/Agency:
|
HL03724/HL/NHLBI NIH HHS; HL51856/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
|
0/Biological Markers; 0/Pulmonary Surfactant-Associated Protein A; 0/Pulmonary Surfactant-Associated Protein D |
| Comments/Corrections | |
Comment In:
|
Crit Care Med. 2003 Jan;31(1):311-3
[PMID:
12545037
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Drotrecogin alfa (activated) administration across clinically important subgroups of patients with s...
Next Document: Risk factors for long intensive care unit stay after cardiopulmonary bypass in children.