BRONCHOALVEOLAR LAVAGE ALTERATIONS IN PULMONARY-EMBOLISM

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.