Prolonged alveolocapillary barrier damage after acute cardiogenic pulmonary edema

C.G. De Pasquale, Leonard Arnolda, I.R. Doyle, R.L. Grant, P.E. Aylward, A.D. Bersten

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    Abstract

    Objectives: To determine whether acute cardiogenic pulmonary edema is associated with damage to the alveolocapillary barrier, as evidenced by increased leakage of surfactant specific proteins into the circulation, to document the duration of alveolocapillary barrier damage in this setting, and to explore the role of pulmonary parenchymal inflammation by determining if circulating tumor necrosis factor-alpha is increased after acute cardiogenic pulmonary edema.Design: Prospective, observational study.Setting: Critical care, cardiac intensive care, and cardiology wards of a tertiary-care university teaching hospital.Patients: A total of 28 patients presenting with acute cardiogenic pulmonary edema and 13 age-matched normal volunteers.Interventions: Circulating surfactant protein-A and -B and tumor necrosis factor-alpha were measured on days 0 (presentation), 1, 3, 7, and 14. Clinical markers of pulmonary edema were documented at the same times.Measurements and Main Results: Surfactant protein-A and -B were elevated on day 0 compared with controls (367+/-17 ng/mL vs. 303+/-17 and 3821+/-266 ng/mL vs. 2747+/-157 [mean SEM], p
    Original languageEnglish
    Pages (from-to)1060-1067
    JournalCritical Care Medicine
    Volume31
    Issue number4
    DOIs
    Publication statusPublished - 2003

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