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Titolo:
Conebulization of surfactant and urokinase restores gas exchange in perfused lungs with alveolar fibrin formation
Autore:
Schermuly, RT; Gunther, A; Ermert, M; Ermert, L; Ghofrani, HA; Weissmann, N; Grimminger, F; Seeger, W; Walmrath, D;
Indirizzi:
Univ Giessen, Zentrum Innere Med, Dept Internal Med, D-35392 Giessen, Germany Univ Giessen Giessen Germany D-35392 ernal Med, D-35392 Giessen, Germany Univ Giessen, Dept Anat, D-35392 Giessen, Germany Univ Giessen Giessen Germany D-35392 Dept Anat, D-35392 Giessen, Germany Univ Giessen, Dept Pathol, D-35392 Giessen, Germany Univ Giessen GiessenGermany D-35392 pt Pathol, D-35392 Giessen, Germany
Titolo Testata:
AMERICAN JOURNAL OF PHYSIOLOGY-LUNG CELLULAR AND MOLECULAR PHYSIOLOGY
fascicolo: 4, volume: 280, anno: 2001,
pagine: L792 - L800
SICI:
1040-0605(200104)280:4<L792:COSAUR>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
RESPIRATORY-DISTRESS-SYNDROME; INSTILLED SURFACTANT; EXOGENOUS SURFACTANT; PULMONARY FIBROSIS; SEVERE PNEUMONIA; RABBIT LUNGS; INJURY; MODEL; ABNORMALITIES; PROCOAGULANT;
Keywords:
urokinase-type plasminogen activator; thrombin; fibrinogen; shunt flow; aerosolization; ventilation-perfusion ratio;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: Schermuly, RT Univ Giessen, Zentrum Innere Med, Dept Internal Med, Klin Str 36, D-35392 Giessen, Germany Univ Giessen Klin Str 36 Giessen Germany D-35392 n, Germany
Citazione:
R.T. Schermuly et al., "Conebulization of surfactant and urokinase restores gas exchange in perfused lungs with alveolar fibrin formation", AM J P-LUNG, 280(4), 2001, pp. L792-L800

Abstract

Alveolar fibrin generation has been suggested to possess strong surfactant-inhibitory potency. In perfused rabbit lungs, fibrin formation in the alveolar space was induced by sequential ultrasonic aerosolization of fibrinogen and thrombin, and the efficacy of rescue administration of surfactant andurokinase was investigated. Ventilation-perfusion ((V) over dotA/(Q) over dot) distribution was assessed by the multiple inert gas elimination technique. Aerosolization of fibrinogen (similar to 20 mg/kg body wt) increased shunt flow to similar to7%. Sequential nebulization of fibrinogen and thrombin (1.3 U/kg body wt) caused alveolar fibrin deposition, documented immunohistologically, and provoked marked shunt flow, progressing to similar to 22% at the end of the experiments. The hemodynamics were virtually unchanged. Rescue aerosolization of natural bovine surfactant (15 mg/kg body wt) or urokinase-type plasminogen activator (4,500 U/kg body wt), undertaken after fibrin formation, improved gas exchange but progressive shunt flow still occurred (efficacy, surfactant. urokinase). In contrast, conebulization of surfactant and urokinase reversed shunt flow to similar to7%, with an increased appearance of normal (V) over dotA/(Q) over dot matching. We conclude that alveolar fibrin formation is a potent surfactant-inhibitory mechanism inintact lungs, provoking severe (V) over dotA/(Q) over dot mismatch with a predominance of shunt flow, and that rescue aerosolization of surfactant plus urokinase may offer restoration of gas exchange under these conditions.

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Documento generato il 04/04/20 alle ore 21:42:37