Assessment of lung injury in the adult respiratory distress syndrome using multiple indicator dilution curves
To assess its usefulness as an index of lung injury in critically ill patients with respiratory failure, the lung microvascular permeability surface area product for urea (/sup 14/C-PSu) was measured using a multiple radioisotopic indicator dilution technique in 10 patients with the adult respiratory distress syndrome (ARDS) and in a control population of 5 patients without ARDS. The mean values for /sup 14/C-PSu and for extravascular lung water (EVLW) were both significantly elevated in patients with ARDS compared with those in control patients (/sup 14/C-PSu: 18.7 +/- 4.4 versus 7.6 +/- 0.7, p less than 0.05; EVLW: 676 +/- 55 versus 269 +/- 53, p less than 0.001); /sup 14/C-PSu and EVLW were significantly correlated (R = 0.52, p less than 0.001). In the patients with ARDS, /sup 14/C-PSu and oxygenation, assessed as the alveolar-arterial oxygen difference, did not appear to be correlated. Repeated measurements of /sup 14/C-PSu were variable in the 3 control patients in whom 4 or more measurements were obtained (SD = 50, 57, and 54% of the mean values, respectively); /sup 14/C-PSu did not predict clinical outcome assessed by survival of individual patients with ARDS. These data suggest that measurement of /sup 14/C-PSu in critically ill patients is a clinically applicable parameter that reflects the degree of microvascular injury in groups of patients. However, our study did not indicate a clear advantage of /sup 14/C-PSu over EVLW in assessing lung injury in this patient population. The variability in /sup 14/C-PSu control patients also suggests that directional changes in /sup 14/C-PSu, as a measure of changes in the degree of lung microvascular dysfunction, should be interpreted with caution.
- Research Organization:
- Univ. of Pittsburgh School of Medicine, PA
- OSTI ID:
- 5270944
- Journal Information:
- Am. Rev. Respir. Dis.; (United States), Vol. 6
- Country of Publication:
- United States
- Language:
- English
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Related Subjects
BLOOD VESSELS
PERMEABILITY
LUNGS
INJURIES
UREA
MEMBRANE TRANSPORT
CARBON 14 COMPOUNDS
ISOTOPE DILUTION
OXYGEN
PATIENTS
RESPIRATION
RESPIRATORY SYSTEM DISEASES
AMIDES
BODY
CARBONIC ACID DERIVATIVES
CARDIOVASCULAR SYSTEM
DISEASES
ELEMENTS
ISOTOPE APPLICATIONS
LABELLED COMPOUNDS
NONMETALS
ORGANIC COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
ORGANS
RESPIRATORY SYSTEM
TRACER TECHNIQUES
550601* - Medicine- Unsealed Radionuclides in Diagnostics