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Surfactant abnormalities in patients with respiratory failure after multiple trauma
U Pison1, W Seeger, R Buchhorn
1Department of Trauma-Surgery, University of Essen, Federal Republic of Germany.
The American Review of Respiratory Disease
|October 1, 1989
Summary
Surfactant abnormalities, including decreased phosphatidylcholine, occur in severely injured patients with post-traumatic pulmonary dysfunction. These lung surfactant changes correlate with respiratory failure severity.
Area of Science:
- Pulmonary Medicine
- Critical Care
- Biochemistry
Background:
- Post-traumatic pulmonary dysfunction (PTPD) is a serious complication in severely injured patients.
- Alveolar surfactant plays a crucial role in lung function and its abnormalities may contribute to PTPD.
Purpose of the Study:
- To investigate surfactant abnormalities in severely injured patients during PTPD.
- To correlate these abnormalities with the severity of respiratory failure.
Main Methods:
- Prospective study analyzing bronchoalveolar lavage fluid from 17 severely injured patients over 14 days post-trauma.
- Assessed alveolar phospholipid composition and in vitro surfactant function.
- Compared data with 10 healthy controls and correlated findings with respiratory failure severity.
Main Results:
- Traumatized patients showed decreased phosphatidylcholine (%PC) and phosphatidylglycerol, with increased phosphatidylinositol, phosphatidylethanolamine, and sphingomyelin.
- A marked decrease in surfactant function (hysteresis area) was observed, correlating with decreased %PC.
- Surfactant alterations and protein leakage were more pronounced in patients with severe respiratory failure.
Conclusions:
- Surfactant abnormalities are present during post-traumatic pulmonary dysfunction.
- These lung surfactant alterations are correlated with the severity of respiratory failure.
- Protein leakage may precede surfactant changes in severe cases.