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Plasma elastase levels and the development of the adult respiratory distress syndrome.
Donnelly, S C; MacGregor, I; Zamani, A; Gordon, M W; Robertson, C E; Steedman, D J; Little, K; Haslett, C.
Afiliação
  • Donnelly SC; Respiratory Medicine Unit, Rayne Laboratory, University of Edinburgh, Scotland.
Am J Respir Crit Care Med ; 151(5): 1428-33, 1995 May.
Article em En | MEDLINE | ID: mdl-7735596
ABSTRACT
Inflammatory cells, particularly neutrophil granulocytes, have been implicated in the pathogenesis of the adult respiratory distress syndrome (ARDS). In this study, we investigated whether a relationship exists between neutrophil elastase in the plasma of multiple-trauma patients on initial hospital presentation and the subsequent development of lung injury and ARDS. Sixty-one multiple-trauma patients were enrolled prospectively. Neutrophil elastase was measured by a specific radioimmunoassay, and analysis was performed by nonparametric statistical methods. A highly significantly elevated plasma elastase level was found in patients who progressed to ARDS (median 217 ng/ml, range 127 to 480) (n = 8) compared with those who did not (median 117 ng/ml, range 21.4 to 685) (n = 53) (p = 0.009). Significant correlation was found between initial elastase values and subsequent requirement for mechanical ventilation (p = 0.01), lowest arterial oxygen saturation/oxygen supplementation recorded (p = 0.003), and organ failure score (p = 0.006). This study shows that within minutes of the initiating trauma event, there is evidence of enhanced neutrophil degranulation as manifested by elevated levels of immunoreactive neutrophil elastase in the peripheral blood. The level of this enzyme correlates with the degree of subsequent lung injury and ARDS. These findings reinforce the importance of neutrophils and their secretory products in early ARDS disease pathogenesis.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Síndrome do Desconforto Respiratório / Elastase Pancreática Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Respir Crit Care Med Assunto da revista: TERAPIA INTENSIVA Ano de publicação: 1995 Tipo de documento: Article País de afiliação: Reino Unido
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Síndrome do Desconforto Respiratório / Elastase Pancreática Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Respir Crit Care Med Assunto da revista: TERAPIA INTENSIVA Ano de publicação: 1995 Tipo de documento: Article País de afiliação: Reino Unido