Endothelin in the Adult Respiratory Distress Syndrome

Abstract

The Adult Respiratory Distress Syndrome, ARDS, is a major cause of morbidity and mortality in the intensive care setting. ARDS can be caused by a variety of illnesses, including systemic sepsis, trauma and burns. However, all form of ARDS have in common an initial pulmonary endothelial injury, leading to pulmonary edema and respiratory failure. Later activation of secondary mediators causes thrombosis and pulmonary vascular muscularization, which narrows the pulmonary bed, resulting in pulmonary hypertension. Many of the mediators of this process are as yet unknown. Endothelin-1 (ET-1) is recently described vasoconstrictor peptide which has potent smooth muscle-mitogenic activity in vitro. Through these actions, ET-1 might contribute to the progression of vascular narrowing in ARDS. We therefore measured ED-1 levels in patients with ARDS.