| Surfactant composition reflects lung overinflation and arterial oxygenation in patients with acute lung injury. | |
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MedLine Citation:
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PMID: 9727778 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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A D Bersten; I R Doyle; K G Davidson; H A Barr; T E Nicholas; F Kermeen |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology Volume: 12 ISSN: 0903-1936 ISO Abbreviation: Eur. Respir. J. Publication Date: 1998 Aug |
Date Detail:
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Created Date: 1998-11-20 Completed Date: 1998-11-20 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8803460 Medline TA: Eur Respir J Country: DENMARK |
Other Details:
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Languages: eng Pagination: 301-8 Citation Subset: IM |
Affiliation:
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Dept of Critical Care Medicine, School of Medicine, Flinders University, Adelaide, South Australia, Australia. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Blood-Air Barrier
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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:
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0/Pulmonary Surfactants; 7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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