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  • 1
    ISSN: 1432-1238
    Keywords: ARDS ; Alveolar cells ; Bronchoalveolar lavage ; Lung contusion ; Polytrauma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To determine whether alveolar cells are involved in the pathogenesis of adult respiratory distress syndrome (ARDS), we assessed the distribution and function of alveolar cells from 30 polytraumatized patients with trauma-induced respiratory failure, 5 of whom also had lung contusion. Cells were obtained by bronchoalveolar lavage performed daily begining on the day of trauma and continuing for 14 days. Neutrophils constituted about 60% of lavage cells in ARDS patients with lung contusion 0–2 days after polytrauma and about 50% in ARDS patients without lung contusion. In ARDS patients with lung contusion the neutrophil fraction decreased to 52% 3–6 days after trauma and to 40% 7–14 days after trauma. In patients without lung contusion the neutrophil fraction increased to 77% and then decreased to 60% at these times. Total cell counts in ARDS patients with lung contusion were more than twice as high as in patients without lung contusion 0–2 days after trauma. The difference in total cell counts decreased during days 3–6 and disappeared by day 7. In all patients morphologically altered alveolar cells were observed 4 days and more after trauma. In non-survivors significantly more altered cells were found. The chemiluminescence-response pattern of the alveolar cells was enhanced throughout the study and correlated with the neutrophil fraction (r=0.6). The neutrophil fraction also correlated with the pulmonary vascular resistance during the first two days after trauma (r=0.53). We conclude that alveolar cells are involved in the pathogenesis of trauma-induced ARDS and that the alveolar cell distribution is different in patients with and without lung contusion during the development of posttraumatic respiratory failure.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 372 (1987), S. 833-833 
    ISSN: 1435-2451
    Keywords: Sepsis syndrome ; Immunology ; Polytrauma organ failure ; Bronchoalveolar lavage ; Polytrauma ; Immunologie ; BAL ; Organversagen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Prospektive immunologische Untersuchungen in der bronchoalveolären Lavage, im Blut und im Urin bei Polytraumatisierten sollten Marker zur Erkennung der Frühphase der Sepsis aufdecken. Die Sepsis begann bei 7 Patienten initial mit einer alveolären Zellaktivierung (Veränderung der Zellzahl und -funktion) durch Mediatorsubstanzen (Elastase, Komplementspaltprodukte, Àrachidonsäuremetabolite). Die Organschäden von Lunge, Niere, Leber und Herz-Kreislauf entwikkelten sich im Sinne von sekundären Funktionsstörungen erst 4 Tage später. Durch die Frühdiagnostik solcher Veränderungen konnten frühe therapeutische Konsequenzen eingeleitet werden.
    Notes: Summary Prospective immunological monitoring using bronchoalveolar lavage, as well as urine and blood tests in patients with multiple injuries, revealed early signs of sepsis development. Sepsis initially began in 7 patients with alveolar cell activation and capillary leakage. Lung, kidney, liver, and heart failure occurred 4 days later in the form of secondary functional disturbances. These early diagnostic signs made appropriate therapy possible.
    Type of Medium: Electronic Resource
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