Effects of Hydroxyethyl Starch 130/0.4 on Pulmonary Capillary Leakage and Cytokines Production and NF-κB Activation in CLP-Induced Sepsis in Rats

2006 ◽  
Vol 135 (1) ◽  
pp. 129-136 ◽  
Author(s):  
Xiaomei Feng ◽  
Wei Yan ◽  
Xiaoming Liu ◽  
Manlin Duan ◽  
Xinhua Zhang ◽  
...  
Keyword(s):  
Hydroxyethyl Starch ◽  
Capillary Leakage ◽  
Pulmonary Capillary

scholarly journals Pulmonary oedema following exercise in humans

2006 ◽  
Vol 31 (6) ◽  
pp. 759-760
Author(s):  
Alastair N.H. Hodges
Keyword(s):  
Pulmonary Oedema ◽  
Hypoxic Condition ◽  
Capillary Leakage ◽  
Lung Density ◽  
Subsequent Work ◽  
Cycling Exercise ◽  
Capillary Stress ◽  
Pulmonary Capillary ◽  
Oxygen Condition ◽  
Exercise Induced

Sub-clinical transient pulmonary oedema has been observed following exercise in both animals and, to some degree, humans. It has been proposed that transient pulmonary oedema, resulting from either pulmonary capillary leakage or capillary stress failure, may limit diffusion in the lung during and after exercise. Initially, to determine the minimal tolerable FIO2 for subsequent work in hypoxia, 10 aerobically trained males (VO2 max, 57.2 ± 7.95 mL·kg–1·min–1; age, 29.6 ± 5.8 y; height, 181.1 ± 8.3 cm; mass, 79.4 ± 5.6 kg) performed graded cycling work to maximal effort under 4 conditions of varying FIO2 (21%, 18%, 15%, and 12%) in a randomized blinded fashion. VO2 max and minimal SaO2 were significantly reduced while breathing 15% and 12% oxygen (VO2 max, 48.2 ± 7.9 and 31.5 ± 7.4 mL·kg–1·min–1, respectively). In the 12% oxygen condition, the majority of the subjects were not able to complete maximal exercise without SaO2 falling below 70%. Subsequently, to determine if transient pulmonary oedema occurs after sustained exercise, 10 highly trained male athletes (VO2 max, 65.0 ± 7.5 mL·kg–1·min–1; age, 25.9 ± 4.7 y; height, 184.1 ± 8.2 cm; mass, 79.4 ± 9.5 kg) underwent assessment of lung density by quantified magnetic resonance imaging before and 54.0 ± 17.2 and 100.7 ± 15.1 min after 60 min of cycling exercise (61.6% ± 9.5% VO2 max). The same 10 subjects underwent an identical measure before and 55.6 ± 9.8 and 104.3 ± 9.1 min after 60 min of cycling exercise (65.4% ± 7.1% hypoxic VO2 max) in hypoxia (FIO2 = 15.0%). Two subjects demonstrated mild exercise-induced arterial hypoxaemia (EIAH) (minSaO2 = 94.5% and 93.8%), and 7 demonstrated moderate EIAH (minSaO2 = 91.4% ± 1.1%) during a preliminary VO2 max test in normoxia. No significant differences (p < 0.05) were found in lung density after exercise in either condition. Mean lung densities, measured once pre- and twice post-exercise, were 0.177 ± 0.019, 0.181 ± 0.019, and 0.173 ± 0.019 g·mL–1 in the normoxic condition, and 0.178 ± 0.021, 0.174 ± 0.022, and 0.176 ± 0.019 g·mL–1 in the hypoxic condition. These results indicate that transient interstitial pulmonary oedema does not occur following sustained steady-state cycling exercise in normoxia or hypoxia. This diminishes the likelihood of pulmonary capillary leakage as a mechanism of transient pulmonary oedema, and, in turn, as a mechanism for changes in SaO2 during sustained exercise.

scholarly journals Activated protein C protects against ventilator-induced pulmonary capillary leak

2009 ◽  
Vol 296 (6) ◽  
pp. L1002-L1011 ◽  
Author(s):  
James H. Finigan ◽  
Adel Boueiz ◽  
Emily Wilkinson ◽  
Rachel Damico ◽  
Jarrett Skirball ◽  
...  
Keyword(s):  
Lung Injury ◽  
Protein C ◽  
Activated Protein C ◽  
Coagulation System ◽  
Blue Dye ◽  
Specific Gene ◽  
Capillary Leakage ◽  
Endothelial Protein C Receptor ◽  
Pulmonary Endothelium ◽  
Pulmonary Capillary

The coagulation system is central to the pathophysiology of acute lung injury. We have previously demonstrated that the anticoagulant activated protein C (APC) prevents increased endothelial permeability in response to edemagenic agonists in endothelial cells and that this protection is dependent on the endothelial protein C receptor (EPCR). We currently investigate the effect of APC in a mouse model of ventilator-induced lung injury (VILI). C57BL/6J mice received spontaneous ventilation (control) or mechanical ventilation (MV) with high (HVT; 20 ml/kg) or low (LVT; 7 ml/kg) tidal volumes for 2 h and were pretreated with APC or vehicle via jugular vein 1 h before MV. In separate experiments, mice were ventilated for 4 h and received APC 30 and 150 min after starting MV. Indices of capillary leakage included bronchoalveolar lavage (BAL) total protein and Evans blue dye (EBD) assay. Changes in pulmonary EPCR protein and Rho-associated kinase (ROCK) were assessed using SDS-PAGE. Thrombin generation was measured via plasma thrombin-antithrombin complexes. HVT induced pulmonary capillary leakage, as evidenced by significant increases in BAL protein and EBD extravasation, without significantly increasing thrombin production. HVT also caused significant decreases in pulmonary, membrane-bound EPCR protein levels and increases in pulmonary ROCK-1. APC treatment significantly decreased pulmonary leakage induced by MV when given either before or after initiation of MV. Protection from capillary leakage was associated with restoration of EPCR protein expression and attenuation of ROCK-1 expression. In addition, mice overexpressing EPCR on the pulmonary endothelium were protected from HVT-mediated injury. Finally, gene microarray analysis demonstrated that APC significantly altered the expression of genes relevant to vascular permeability at the ontology (e.g., blood vessel development) and specific gene (e.g., MAPK-associated kinase 2 and integrin-β6) levels. These findings indicate that APC is barrier-protective in VILI and that EPCR is a critical participant in APC-mediated protection.

RESUSCITATION FROM SEPTIC SHOCK WITH CAPILLARY LEAKAGE: HYDROXYETHYL STARCH (130 KD), BUT NOT RINGER’S SOLUTION MAINTAINS PLASMA VOLUME AND SYSTEMIC OXYGENATION

Shock ◽  
2004 ◽  
Vol 21 (4) ◽  
pp. 336-341 ◽  
Author(s):  
Gernot Marx ◽  
Samantha Pedder ◽  
Linda Smith ◽  
Seshapillai Swaraj ◽  
Steve Grime ◽  
...  
Keyword(s):  
Septic Shock ◽  
Hydroxyethyl Starch ◽  
Plasma Volume ◽  
Capillary Leakage ◽  
Ringer’S Solution

Attenuation of capillary leakage by hydroxyethyl starch (130/0.42) in a porcine model of septic shock

2006 ◽  
Vol 34 (12) ◽  
pp. 3005-3010 ◽  
Author(s):  
Gernot Marx ◽  
Samantha Pedder ◽  
Linda Smith ◽  
Seshapillai Swaraj ◽  
Steve Grime ◽  
...  
Keyword(s):  
Septic Shock ◽  
Hydroxyethyl Starch ◽  
Porcine Model ◽  
Capillary Leakage

scholarly journals COVID-19: the key role of pulmonary capillary leakage. An observational cohort study

2020 ◽  
Author(s):  
Maddalena Alessandra Wu ◽  
Tommaso Fossali ◽  
Laura Pandolfi ◽  
Luca Carsana ◽  
Davide Ottolina ◽  
...  
Keyword(s):  
Lavage Fluid ◽  
Interleukin 10 ◽  
Junctional Complex ◽  
Albumin Concentration ◽  
Capillary Leakage ◽  
Hypoxemic Respiratory Failure ◽  
Respiratory Dysfunction ◽  
Pulmonary Capillary ◽  
Observational Cohort ◽  
Chest X Ray

Background: COVID-19 induces progressive hypoxemic respiratory failure and acute respiratory distress syndrome, mostly due to a dysregulated inflammatory response. Since the first observations of COVID-19 patients, significant hypoalbuminemia was detected. This study aimed to investigate the hypothesis that hypoalbuminemia in COVID-19 patients is due to pulmonary capillary leakage and to test its correlation with indicators of respiratory function. Methods: 174 COVID-19 patients, 92 admitted to the Intermediate Medicine ward (IMW), and 82 to the Intensive Care Unit (ICU) at Luigi Sacco Hospital in Milan were included in this study. Findings: Serum albumin concentration was decreased in the whole cohort, with ICU patients displaying lower values than IMW patients [20 (18-23) vs 28 (24-33) g/L, p<0.0001]. Lower albumin values were found in patients belonging to a more compromised group (lower PaO2 to FiO2 ratio and worst chest X-ray findings). In a subset of 26 patients, analysis of bronchoalveolar lavage fluid (BALF) highlighted high protein concentrations, which were correlated to Interleukin-8 and Interleukin-10 BALF concentration. The length of hospitalisation [20 (15-29) vs 8 (5-14) days, p<0.0001] and death rate (52.4% vs 21.7%, p<0.0001) were higher in ICU than in IMW patients, while a strict relation between hypoalbuminemia and 30 day-survival was detected in the whole cohort. Electron microscopy examinations of eight out of ten autopsy lung tissues showed diffuse loosening of interendothelial junctional complex. Interpretation: The degree of hypoalbuminemia can be considered as a useful severity marker in hospitalised COVID-19 patients. Pulmonary capillary leak syndrome secondary to the hyperinflammatory state plays a key role in the pathogenesis of COVID-19 respiratory dysfunction and should be regarded as a therapeutic target.

N-terminal pro-brain natriuretic peptide reflects pulmonary capillary leakage in patients with acute dyspnea

2004 ◽  
Vol 94 (5) ◽  
pp. 669-670 ◽  
Author(s):  
Antoni Bayes-Genis ◽  
Jesus Bellido-Casado ◽  
Edgar Zapico ◽  
Carlos Cotes ◽  
Jose Belda ◽  
...  
Keyword(s):  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Acute Dyspnea ◽  
Capillary Leakage ◽  
Pulmonary Capillary

Hydroxyethyl starch and modified fluid gelatin maintain plasma volume in a porcine model of septic shock with capillary leakage

2002 ◽  
Vol 28 (5) ◽  
pp. 629-635 ◽  
Author(s):  
G. Marx ◽  
M. Cobas Meyer ◽  
T. Schuerholz ◽  
B. Vangerow ◽  
K. Gratz ◽  
...  
Keyword(s):  
Septic Shock ◽  
Hydroxyethyl Starch ◽  
Plasma Volume ◽  
Porcine Model ◽  
Capillary Leakage ◽  
Modified Fluid Gelatin
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