Simple clinical means of documenting increased pulmonary endothelial permeability to protein

Journal Article · Fri Feb 20 04:00:00 EST 1987 · JAMA, J. Am. Med. Assoc.; (United States)

DOI:https://doi.org/10.1001/jama.1987.03390070073026· OSTI ID:7033255

Mishkin, F S; Niden, A; Kumar, A; Thomas, A; Reese, I C; Vasinrapee, P

The authors investigated a simple method that can be used at the bedside for documenting the net accumulation of albumin in the lung. The technique employs measurement with a computer-linked gamma camera of the activity ratio in an area of the right lung compared with the same-sized area in the heart at 20 minutes and three hours following intravenous injection of technetium Tc 99m albumin. They applied this measurement to three groups of patients: a control group and patients with roentgenographic evidence of edema classified according to clinically available criteria as either hydrostatic edema or permeability edema to see if they could document differences among these groups. In control patients this ratio did not increase by more than seven units between the 20-minute and three-hour measurements. Of 18 patients classified by other routine clinical means as having hydrostatic pulmonary edema, 89% showed no increase in lung albumin accumulation. In 29 patients with permeability edema associated with the so-called adult respiratory distress syndrome, 31% showed evidence of net pulmonary albumin accumulation. These findings suggest that some patients otherwise classified as having hydrostatic edema have concomitant permeability changes in the microvasculature and that permeability edema represents a spectrum of endothelial damage.

• Research Organization: Memorial Medical Center of Long Beach, CA
• OSTI ID: 7033255
• Journal Information: JAMA, J. Am. Med. Assoc.; (United States), Journal Name: JAMA, J. Am. Med. Assoc.; (United States) Vol. 257:7; ISSN JAMAA
• Country of Publication: United States
• Language: English

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550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ALBUMINS
ANIMAL TISSUES
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BODY
CAMERAS
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DIAGNOSTIC TECHNIQUES
DIAGNOSTIC USES
DYNAMIC FUNCTION STUDIES
EDEMA
ENDOTHELIUM
GAMMA CAMERAS
HEART
HOURS LIVING RADIOISOTOPES
INJECTION
INTAKE
INTERMEDIATE MASS NUCLEI
INTRAVENOUS INJECTION
ISOMERIC NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
LUNGS
NUCLEI
ODD-EVEN NUCLEI
ORGANIC COMPOUNDS
ORGANS
PATHOLOGICAL CHANGES
PATIENTS
PERMEABILITY
PROTEINS
RADIOISOTOPE SCANNING
RADIOISOTOPES
RESPIRATORY SYSTEM
SCINTISCANNING
SYMPTOMS
TECHNETIUM 99
TECHNETIUM ISOTOPES
TISSUES
USES
YEARS LIVING RADIOISOTOPES