Document Detail


Surfactant composition reflects lung overinflation and arterial oxygenation in patients with acute lung injury.
MedLine Citation:
PMID:  9727778     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
A D Bersten; I R Doyle; K G Davidson; H A Barr; T E Nicholas; F Kermeen
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The European respiratory journal     Volume:  12     ISSN:  0903-1936     ISO Abbreviation:  Eur. Respir. J.     Publication Date:  1998 Aug 
Date Detail:
Created Date:  1998-11-20     Completed Date:  1998-11-20     Revised Date:  2013-05-23    
Medline Journal Info:
Nlm Unique ID:  8803460     Medline TA:  Eur Respir J     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  301-8     Citation Subset:  IM    
Affiliation:
Dept of Critical Care Medicine, School of Medicine, Flinders University, Adelaide, South Australia, Australia.
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MeSH Terms
Descriptor/Qualifier:
Blood-Air Barrier / physiology
Bronchoalveolar Lavage Fluid / chemistry
Case-Control Studies
Heart Diseases / metabolism,  physiopathology
Humans
Intubation, Intratracheal
Oxygen / blood*
Pulmonary Surfactants / chemistry*,  metabolism
Respiratory Distress Syndrome, Adult / metabolism*,  physiopathology
Respiratory Mechanics / physiology*
Chemical
Reg. No./Substance:
0/Pulmonary Surfactants; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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