Detection of alveolar epithelial injury by 99mTC-DTPA radioaerosol inhalation lung scan following blunt chest trauma.

DTPA clearance rate is a reliable index of alveolar epithelial permeability, and is a highly sensitive marker of pulmonary epithelial damage, even of mild degree. In this study, 99mTc-DTPA aerosol inhalation scintigraphy was used to assesss the pulmonary epithelial membrane permeability and to investigate the possible application of this permeability value as an indicator of early alveolar or interstitial changes in patients with blunt chest trauma. A total of 26 patients was chest trauma (4 female, 22 male, 31-80 yrs, mean age; 53+/-13 yrs) who were referred to the emergency department in our hospital participated in this tsudy. Technetium-99m diethylene triamine pentaacetic acid (DTPA) aerosol inhalation scintigraphy was performed on the first and thirtieth days after trauma. Clearance half times (T1/2) were calculated by placing a mono-exponential fit on the curves. Penetration index (PI) was calculated on the first-minute image. On the first day, mean T1/2 value of the whole lung was 63+/-19 minutes (min), and thirtieth day mean T1/2 value was 67+/-21 min. On the first day, mean PI values of the lung and 30th day mean PI value were 0.60+/-0.05, and 0.63+/-0.05, respectively. Significant changes were observed in radioaerosol clearance and penetration indices. Following chest trauma, clearance of 99mTc-DTPA increased owing to breakdown of the alveolar-capillary barrier. This increase in the epithelial permeability of the lung appears to be an early manifestation of lung disease that may lead to efficient therapy in the early phase.

The time course of recovery following mild thoracic trauma.

PURPOSE: The purpose of this study was to determine when patients are able to return to their normal work or home activities. PATIENTS AND METHODS: Eighty cases, 35 females (44%) and 45 males (56%), presenting to our hospital between the years of 2003 and 2004 were prospectively evaluated. There were no hemopneumothorax or associated injury. The patients were randomized into two groups with respect to treatment modalities as the following: non-steroid anti-inflammatory (NSAIDs) and Tramadol treatment groups. In the follow-up, visual analog scale (VAS), and vital capacity were conducted on the days 0, 2, 7 and 30 and 6 months. The results were statistically analyzed. RESULTS: The mean age of the group receiving NSAIDs was 55.42 +/- 15.72, and for the group receiving tramadol treatment, it was 55.67 +/- 17.23. VAS result was 7.8 +/- 1.8 in those receiving NSAIDs treatment, while it was 8.2 +/- 1.6 in the other group. The vital capacity was 235.54 +/- 82 ml for the former group, and 232.43 +/- 89.44 for the latter. In their follow-up, particularly by the 7th day, significant improvement of VAS and vital capacity were observed (p < 0.01). Maximum improvement was achieved on the 30th day (p < 0.001). There was no change in the 6th month. CONCLUSION: Patients are able to return to their normal work or home activities after 7 days. Patients experienced steadily decreasing pain and improved vital capacity at each time point after injury. No difference in response was seen between the two medications. A significant improvement is observed by the 7th day after the trauma (p < 0.01). Optimal improvement was achieved on the 30th day (p < 0.001).