Lung vascular permeability after reversal of fibronectin deficiency in septic sheep. Correlation with patient studies.
Lung vascular permeability after reversal of fibronectin deficiency in septic sheep. Correlation with patient studies.
复制标题
脓毒症绵羊纤连蛋白缺乏逆转后的肺血管通透性。
DOI：
10.1097/00000658-198311000-00016
复制
发表时间：
1983
影响因子：
9
通讯作者：
PowersJr,SR
中科院分区：
文献类型：
--
作者：
Saba,TM;Niehaus,GD;Scovill,WA;Blumenstock,FA;Newell,JC;HolmanJr,J;PowersJr,SR
血浆纤维连接蛋白缺乏和听觉功能障碍存在于危重感染性手术、创伤和烧伤患者多器官功能衰竭。纤维连接蛋白缺乏可通过输注新鲜血浆低温沉淀逆转。探讨人低温沉淀治疗对脓毒症绵羊术后血浆纤维连接蛋白缺乏肺血管通透性的影响。此外，我们还对脓毒症手术和创伤患者输注血浆低温沉淀后的肺功能进行了选择性研究。在患者中，通过多重惰性气体消除技术测量，通气-灌注平衡似乎有所改善。在纤维连接蛋白缺陷羊肺淋巴瘘制备中，输注人血浆冷沉淀（10单位；250 ml）可延缓假单胞菌脓毒症（5× 10 9细菌，IV； 5× 10 10细菌，IP）术后肺血管通透性的增加，并使其最小化。例如，在第一组绵羊中，脓毒症绵羊（n= 4）在2小时时仅用生理盐水（容量控制）处理的经血管蛋白清除率（TPC）为20.1±3.1 ml/hr，而用富含纤维连接蛋白的冷沉淀处理的绵羊（n= 4）的TPC为11.23±0.83 ml/hr （p< 0.05）。在第二组羊中，用亲和层析法去除纤维连接蛋白的低温沉淀作为对照溶液。在肺血管通透性方面也没有表现出这种保护作用。因此，在2小时时，给予纤维连接蛋白缺乏的冷冻沉淀的败血性羊的淋巴流量（Q lym）为30.2 ml/hr，经血管蛋白清除率（TPC）为18.0 ml/hr。相比之下，在富含纤维连接蛋白的低温沉淀处理的绵羊中，Q lym为14.8 ml/hr， TPC为8.12 ml/hr。提示纤连蛋白可能影响手术和创伤后脓毒症患者肺血管的完整性。
Plasma fibronectin deficiency and opsonic dysfunction exist in critically ill septic surgical, trauma, and burn patients with multiple organ failure. Fibronectin deficiency can be reversed by infusion of fresh plasma cryoprecipitate. The influence of therapy with human cryoprecipitate on lung vascular permeability in septic sheep with plasma fibronectin deficiency following surgery was evaluated. Additionally, selected studies on pulmonary function in septic surgical and trauma patients after infusion of plasma cryoprecipitate were completed. In patients, ventilation-perfusion balance appeared to improve as measured by the multiple inert gas elimination technique. With the lung lymph fistula preparation in fibronectin deficient sheep, infusion of human plasma cryoprecipitate (10 units; 250 ml) delayed the onset and minimized the increase in lung vascular permeability during postoperative Pseudomonus sepsis (5× 10 9 bacteria, IV; 5× 10 10 bacteria, IP). For example, in a first group of sheep, the transvascular protein clearance (TPC) at 2 hrs in septic sheep (n= 4) treated with only saline (volume control) was 20.1±3.1 ml/hr, compared to 11.23±0.83 ml/hr in the sheep (n= 4) treated with fibronectin-rich cryoprecipitate (p< 0.05). In a second group of sheep, cryoprecipitate depleted of fibronectin by affinity chromatography was used as the control solution. It also did not manifest this protective effect with respect to lung vascular permeability. Thus, at 2 hrs the lymph flow (Q lym) was 30.2 ml/hr and the transvascular protein clearance (TPC) was 18.0 ml/hr in septic sheep given fibronectin-deficient cryopre cipitate. In contrast, in the fibronectin-rich cryoprecipitate treated sheep, the Q lym was 14.8 ml/hr and the TPC was 8.12 ml/hr. It is suggested that fibronectin may influence lung vascular integrity during sepsis following surgery and trauma.