ARDS : early diagnosis & prevention of irreversible change by surfactant therapy

ARDS：早期诊断

基本信息

批准号：
07457353
负责人：
KOBAYASHI Tsutomu
金额：
$ 4.67万
依托单位：
Kanazawa University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
1995
资助国家：
日本
起止时间：
1995 至 1997
项目状态：
已结题

项目摘要

(1) Determination of the reversible period in adult (acute) respiratory distress syndrome (ARDS) : In experiment to administrate endotoxin, elastase, lysolecithin, and anti-surfactant protein B monoclonal antibody in rats and rabbits, the ARDS-like symptom could be reversed by surfactant replacement until 6 hours after the arterial oxygen pressure (PaO_2) started to decrease. Therefore, 6 hours after the onset of the symptom was thought to be the reversible period. Formation of hyaline membrane, however, was noted in the alveoli even at the reversible period, uggesting that some cares should be taken to prevent the organic changes as early as possible.(2) Replacement method of surfactant and development of artificial surfactant : In rats, inhalation of an aerosolized surfactant (modified natural surfactant, Surfactant CK) reversed symptoms of ARDS-like lung injury which was induced by administration of endotoxin. By this procedure, the organic change of the lung tissue, an irreversible damage, could be postponed at least for 6 hours. In addition, an artificial surfactant which was prepared with synthetic dipalmitoyl-phosphatidylcholine, phosphatidylglycerol and dioleoylphosphatidylcholine (60 : 20 : 20) plus surfactant protein B (0.7%) and C (1.4%) exhibited the same effects with Surfactant CK.(3) Relation between condition of pulmonary surfactant and vascular resistance : We found that inactivation of pulmonary surfactant induces dilatation of the capillary vessels of the alveoli. We think that this is an important finding to explain the mechanism of hypoxemia in ARDS.(4) Early diagnosis of ARDS : We have obtained some findings that surface tension values of the liquid aspirated from the trachea may by useful for early diagnosis of ARDS.

(1) Determination of the reversible period in adult (acute) respiratory distress syndrome (ARDS) : In experiment to administrate endotoxin, elastase, lysolecithin, and anti-surfactant protein B monoclonal antibody in rats and rabbits, the ARDS-like symptom could be reversed by surfactant replacement until 6 hours after the arterial oxygen pressure (PaO_2) started to 减少。因此，症状发作后6小时被认为是可逆的时期。然而，即使在可逆的时期，在肺泡中也注意到了透明膜的形成，应采取一些措施，以防止尽早防止有机变化。（2）表面活性剂的替换方法和人工表面活性剂的开发：在大鼠中，在大鼠中，对经过改良的表面效果，对经过改良的表面效果，对症状的表面表面效果，效果，这些症状的效果，效果，表面表面效果，cack cack cack cack cack cack cack cack cack cack cack cack cack cack cack cack cack cack cack cack cack cack cack cack cack cack cack cack cack。肺损伤是由内毒素施用引起的。通过此过程，肺组织的有机变化至少可以推迟6小时。此外，使用合成二氨酰磷脂酰胆碱，磷脂酰甘油和二烯酰磷脂酰胆碱（60：20：20）加上表面活性剂B（0.7％）和C（1.4％）在外表ck（3）ck（3）表现出相同的效果（3）（3）（3）（3）的效果的人工表面活性剂（60：20：20）加上表面活性剂蛋白B（0.7％）和ck。我们发现，肺表面活性剂的失活会诱导肺泡的毛细血管血管扩张。我们认为，这是解释ARDS中低氧血症的机制的重要发现。（4）ARDS的早期诊断：我们已经获得了一些发现，从气管吸入的液体的表面张力值可能可通过对ARDS的早期诊断来有用。