Chest
Clinical Investigations in Critical CareExhaled Breath Condensate Isoprostanes Are Elevated in Patients With Acute Lung Injury or ARDS
Section snippets
Patients
Patients with or at risk for ALI/ARDS due to severe sepsis were studied. Specific inclusion criteria included the presence of the systemic inflammatory response syndrome and at least one acute organ failure. To meet criteria for systemic inflammatory response syndrome, three or more of the following were demonstrated: core temperature ≥ 38°C (100.4°F) or ≤ 36°C (96.8°F); heart rate ≥ 90/min (in the absence of β-blocker therapy or complete heart block); respiratory rate ≥ 20/min or minute
Results
Twenty-two patients with or at risk for ALI/ARDS were studied. All patients met the criteria for severe sepsis as outlined in the Materials and Methods section, and all were mechanically ventilated. Twenty of the 22 met criteria for either ALI or ARDS. The mean age was 52 ± 3 years. Twelve were male and 10 were female. Seven patients also met criteria for shock, five for acute renal insufficiency, and three for coagulation dysfunction. The overall mortality of the patients with or at risk for
Discussion
The oxidant stress theory of ARDS proposes that an insult, such as severe sepsis, leads to activation of neutrophils and macrophages that subsequently release reactive oxygen species. These oxygen free radicals, while clearly beneficial in host defense, may result in lipid peroxidation of endothelial and epithelial cell membrane phospholipids, thereby altering the structure and function of the cell membrane. Such alterations could significantly compromise barrier function.
Attempts to quantify
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Supported by National Institutes of Health grants 5 ROI HL 55198, HL 43167, and HL 19153 (SCOR in ALI), and The PPH Cure Foundation.