Alveolar Surfactant Function in Severely Injured Patients
Lack of Surfactant material is the underlying abnormality of the respiratory distress syndrome in preterm infants [1–3]. Surfactant abnormalities have also been implicated in the development of adult respiratory distress in adults (ARDS) . This view is supported by similarities in pulmonary failure between patients with ARDS and preterm babies with respiratory distress syndrome, as well as diffuse alveolar collapse suggesting altered surfactant properties in ARDS. Mechanisms of surfactant alteration in the course of ARDS could not only include absolute lack of surface-active compounds, but also alterations in its phospholipid or protein composition [5, 6]. There are several lines of evidence that increased lung endothelial and epithelial permeability is the decisive step in the development of ARDS or different etiology [7–11]. Subsequent leakage of protein-rich edema fluid into the interstitial and the alveolar space has been implicated in alterations of surfactant properties due to protein surfactant interaction [12–16].
KeywordsPermeability Surfactant Glycerol Sodium Chloride Serine
Unable to display preview. Download preview PDF.
- 2.Avery ME, Mead J (1959) Surface properties in relation to atelectasis and hyaline membrane disease. Am J Dis Child 97:517–523Google Scholar
- 3.Notier RH, Shapiro DL (1981) Lung surfactant in an era of replacement therapy. Pediatrics 68:781–789Google Scholar
- 5.Kulovich MV, Gluck L (1979) The lung profile. II. Complicated pregnancy. Am J Ostet Gynecol 135:64–70Google Scholar
- 8.Traber DL (1985) Pulmonary microvascular dysfunction during shock. In: Janssen HF ,Barnes GD (eds) Circulatory shock: basic and clinical implications. Academic ,New York ,pp 23–46Google Scholar
- 10.Repine JE ,Tate RM (1983) Oxygen radicals and lung edema. Physiologist 26:171–181Google Scholar
- 13.Tierney DF ,Johnson RP (1965) Altered surface tension of lung extracts and lung mechanics. J Appl Physiol 20:1253–1260Google Scholar
- 19.Hallman M, Spragg R, Harrell JH ,Moser KM ,Gluck L (1982) Evidence of lung surfactant abnormality in respiratory failure. Study of bronchoalveolar lavage phospholipids ,surface activity ,phospholipase activity ,and plasma myoinositol. J Clin Invest 70:673–683Google Scholar
- 23.Henry RJ (1964) J Clinical Chemistry. Harper and Row ,New YorkGoogle Scholar
- 32.Obertacke U, Kalotai J, Coenen T, Joka T, Schmit-Neuerburg KP (1989) Ein linearer ARDS-Schweregradscore (0–1). (submitted)Google Scholar