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Related Experiment Videos

Increased lung capillary permeability after trauma: a prospective clinical study.

J A Sturm, D H Wisner, H J Oestern

    The Journal of Trauma
    |May 1, 1986
    PubMed
    Summary

    Severe trauma increases pulmonary capillary permeability, detectable by albumin extravasation scintigraphy within 24 hours. Standard lung function tests and extravascular lung water measurements do not show significant changes until 48 hours post-trauma.

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    Area of Science:

    • Pulmonary Medicine
    • Trauma Research
    • Medical Imaging

    Background:

    • Severe trauma can lead to pulmonary dysfunction.
    • Assessing early changes in lung permeability is crucial for understanding trauma response.
    • Traditional methods may not detect subtle, early pulmonary changes.

    Purpose of the Study:

    • To prospectively investigate pulmonary dysfunction and permeability in severely traumatized patients.
    • To compare traditional ventilatory parameters and extravascular lung water with scintigraphic albumin extravasation.
    • To determine the timing of pulmonary capillary permeability changes after severe trauma.

    Main Methods:

    • Prospective study of severely traumatized patients.
    • Measurement of ventilatory parameters: PaO2/FiO2, dynamic compliance, per cent shunt, A-a DO2.

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  • Scintigraphic determination of pulmonary albumin extravasation and extravascular lung water (EVLW).

    • Main Results:

    • Albumin extravasation scintigraphy showed increased pulmonary capillary permeability shortly after trauma (median 3.6 X 10(-5)/sec within 24 hours).
    • Eighty percent of patients within 48 hours of trauma exceeded normal albumin extravasation limits.
    • Traditional parameters (PaO2/FiO2, compliance, shunt, A-a DO2, EVLW) did not significantly deteriorate until 48 hours post-trauma.

    Conclusions:

    • Severe multiple trauma induces an early increase in pulmonary capillary permeability.
    • Albumin extravasation scintigraphy is a sensitive method for detecting early pulmonary capillary permeability changes after trauma.
    • These early permeability changes are not detectable by commonly used clinical measures.