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Prophylactic treatment in the adult respiratory distress syndrome
1Dr. M. Nasta Institute of Pneumophtisiology, Bucharest, Romania.
Abstract:
This article summarizes some ways of prophylactic treatment in adult respiratory distress syndrome (ARDS) such as the prevention of the appearance and/or of the rise of the TNF levels and the prevention of the activation or of the damaging capabilities of the activated neutrophil in ARDS, and also the ways related to the prevention of the action of other mediators involved in the inflammatory processes, such as the C5a complement component or the leukotrienes. We can treat prophylactically the "at risk" group for ARDS before the appearance of clinical symptoms, prior to endotoxin with corticosteroids or anti-TNF monoclonal antibodies. Another way could be the inhibition of the TNF production at the transcription level with iloprost or at the translation level with pentoxifylline (PTX). For preventing the neutrophil damaging capabilities, we can modify its structure and functions rendering it defective or we can decrease the neutrophil adherence by using antibodies antiadhesion molecules, iloprost or PTX, and we can prevent neutrophil activation and the release of oxidants in the circulation by using the fluid phase of GMP 140.