Inflammation product effects on dilatational mechanics can trigger the Laplace instability and acute respiratory distress syndrome
Inflammation product effects on dilatational mechanics can trigger the Laplace instability and acute respiratory distress syndrome
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DOI：
10.1039/d0sm00415d
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发表时间：
2020-08-07
期刊：
影响因子：
3.4
通讯作者：
Zasadzinski, Joseph A.
中科院分区：
文献类型：
--
作者：
Barman, Sourav;Davidson, Michael L.;Zasadzinski, Joseph A.
在肺中，小肺泡的拉普拉斯压，增量P=2伽马/R比大肺泡的高，除非表面张力伽马随肺泡界面面积A而减小，使得2埃伽马，其中埃=A(d伽马/达)是扩张模数。在急性呼吸窘迫综合征(ARDS)中，由于对潜在创伤或疾病的免疫反应而产生的脂肪酶活性，通过细菌、病毒和正常细胞膜中双链磷脂的水解，导致肺泡液中单链溶质脂浓度增加。如果可溶性溶菌脂有足够的时间扩散出界面，则增加的溶菌脂浓度会显著降低呼吸频率下的扩张系数，导致2epsion 0，这可能解释了ARDS患者从高频振荡通气中获得的好处。
In the lungs, the Laplace pressure, Delta P= 2 gamma/R, would be higher in smaller alveoli than larger alveoli unless the surface tension,gamma decreases with alveolar interfacial area,A, such that2 epsilon>gamma in which epsilon=A(d gamma/dA) is the dilatational modulus. In Acute Respiratory Distress Syndrome (ARDS), lipase activity due to the immune response to an underlying trauma or disease causes single chain lysolipid concentrations to increase in the alveolar fluidsviahydrolysis of double-chain phospholpids in bacterial, viral, and normal cell membranes. Increasing lysolipid concentrations decrease the dilatational modulus dramatically at breathing frequencies if the soluble lysolipid has sufficient time to diffuse off the interface, causing 2 epsilon 0, which may explain the benefits ARDS patients receive from high frequency oscillatory ventilation.