G. Nakos et al., BRONCHOALVEOLAR LAVAGE ALTERATIONS IN PULMONARY-EMBOLISM, American journal of respiratory and critical care medicine, 158(5), 1998, pp. 1504-1510
Citations number
43
Categorie Soggetti
Emergency Medicine & Critical Care","Respiratory System
The objective of this study was to determine quantitative and qualitat
ive surfactant alterations, proteins, and platelet activating factor (
PAF) in bronchoalveolar lavage (BAL) fluid from patients with pulmonar
y thromboembolism (PTE) with respect to ventilated patients without PT
E. Patients with PTE underwent BAL at the most affected lung area on t
he first and tenth days of PTE diagnosis. Total proteins and albumin,
total lipids, individual phospholipid classes, PAF and PAF-acetylhydro
lase (PAF-AcH) activity were determined in BAL fluid. Total proteins a
nd albumin were found to be increased in both successive samples of pa
tients with PTE when compared with the control group (p < 0.001 and p
< 0.05, respectively). Total phospholipids, though, were elevated on t
he first day, but they decreased on the tenth day, in comparison with
the control groups (p < 0.05). Alterations in the percentage of indivi
dual phospholipid classes were observed in both successive samples of
BAL fluid when compared with those in the control subjects. PAF and PA
F-AcH were detected in high levels on the first day (p < 0.001), which
were reduced on the tenth day (p < 0.05). An inverse correlation betw
een PAF levels and Pa-o2/FIO2 ratio was observed. Finally, the percent
age of macrophages decreased and the percentage of neutrophils increas
ed during the course of PTE. In conclusion, pulmonary embolism is asso
ciated with alterations in lung surfactant and inflammation in lung ti
ssue, expressed by an increase in PAF and in neutrophils.