G. Nakos et al., PROTEINS AND PHOSPHOLIPIDS IN BAL FROM PATIENTS WITH HYDROSTATIC PULMONARY-EDEMA, American journal of respiratory and critical care medicine, 155(3), 1997, pp. 945-951
Citations number
49
Categorie Soggetti
Emergency Medicine & Critical Care","Respiratory System
The purpose of the present study is twofold: to evaluate alterations i
n total phospholipid content and individual phospholipid classes of th
e surfactant, and to detect markers of inflammatory reaction in bronch
oalveolar lavage (BAL) from patients with hydrostatic pulmonary edema
(HPE). Mechanically ventilated patients with HPE (Group 1) were compar
ed with mechanically ventilated patients without cardiopulmonary disea
se (Group 2), considered as the control group. Group 3, including pati
ents with high-permeability pulmonary edema, was used for further comp
arison. BAL was obtained and immediately cooled at 4 degrees C. Total
proteins, albumin, and platelet-activating factor-acetylhydrolase (PAF
-AcH) were measured. Total lipids were extracted and analyzed after th
in-layer chromatographic separation. PAF was determined with bioassay.
Total BAL proteins and albumin were found significantly higher in pat
ients with HPE compared with control, but were lower compared with adu
lt respiratory distress syndrome (ARDS). PAF was elevated in patients
with HPE and ARDS, whereas in the control group it was actually in non
detectable levels. PAF was significantly higher in ARDS than in HPE pa
tients. BAL neutrophils concentration was higher in HPE compared with
control, but lower compared with ARDS. There was an inverse correlatio
n between PAF-AcH and PAF. Quantitative reduction of total BAL phospho
lipids (PL) and qualitative deficiency was observed in both patients w
ith HPE and ARDS. The findings of this study suggest that there is evi
dence of inflammation in the airspaces of patients with HPE.