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Pulmonary edema in meningococcal septicemia associated with reduced epithelial chloride transport

Michael Eisenhut1, Helen Wallace, Paul Barton

  • 1Institute of Child Health, University of Liverpool, UK. michael_eisenhut@yahoo.com

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|February 1, 2006
PubMed

Insights

Meningococcal septicemia can cause pulmonary edema due to abnormal epithelial sodium and chloride transport. Reduced chloride transport is linked to respiratory issues in children with this condition.

Area of Science:

  • Pediatric critical care medicine
  • Respiratory medicine
  • Nephrology

Background:

  • Meningococcal septicemia can lead to life-threatening pulmonary edema.
  • The underlying mechanisms, particularly epithelial transport abnormalities, require further investigation.

Purpose of the Study:

  • To investigate if meningococcal septicemia-related pulmonary edema is linked to systemic epithelial sodium and chloride transport abnormalities.
  • To explore associations with hormones regulating sodium transport.

Main Methods:

  • Prospective observational study in a pediatric intensive care unit.
  • Recruited children with meningococcal septicemia (with and without pulmonary edema) and controls with noninfectious critical illness.
  • Measured sweat/saliva electrolytes, renal excretion, nasal potential difference, and hormone levels.

Main Results:

  • Patients with pulmonary edema showed higher sweat/saliva sodium and chloride concentrations and renal sodium excretion.
  • Reduced chloride transport in the nasal airway correlated with respiratory compromise.
  • Hormone levels (aldosterone, thyroxine, cortisol) did not differ significantly between groups.

Conclusions:

  • Confirmed association between meningococcal septicemia-related pulmonary edema and impaired systemic sodium and chloride transport.
  • Reduced chloride transport is closely linked to respiratory compromise, evidenced by nasal potential difference findings.
Abstract

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