-transparent.png){kind=logo}
OBJECTIVE The aim of this study was to investigate the direct influence of lung contusion on pulmonary surfactant in multiple trauma patients. METHODS Prospective, nonrandomized study. METHODS University hospital, trauma intensive care unit. METHODS Eighteen multiple trauma patients with unilateral lung contusions and Injury Severity Scores >19 were studied prospectively. METHODS Bronchoalveolar lavage was performed daily until either day 7 or extubation. Samples from the side of lung contusion (n = 62) and the contralateral, uninjured side (n = 62) were obtained at the same time in 14 patients. Total phospholipids, total phospholipid classes, and surfactant apoprotein A were quantified. Additionally, surfactant function was measured with a pulsating bubble surfactometer in four patients. All data are presented as mean +/- SEM. Statistical analyses were performed using programs of SPSS for Windows 6.1.3 (SPSS Inc., Chicago, IL) (Student's t-test; p < .05). RESULTS Total phospholipids were significantly increased on the side of lung contusion (contusion side, 40+/-7 microg/mL; contralateral side, 21+/-3 microg/mL; p = .004). The percentage contents of phosphatidylcholine (contusion side, 87.1%+/-1.0%; contralateral side, 84.3%+/-1.0%; p = .04) and sphingomyelin (contusion side, 2.9%+/-0.3%; contralateral side, 1.9%+/-0.2%; p = .004) were significantly higher. In contrast, the percentage content of phosphatidylglycerol was significantly decreased (contusion side, 4.1%+/-0.1%; contralateral side, 6.9%+/-0.6%; p = .001). No alterations were found for the relative contents of phosphatidylethanolamine (contusion side, 2.4%+/-0.2%; contralateral side, 2.2%+/-0.2%; p = .47), phosphatidylinositol (contusion side, 3.5%+/-0.4%; contralateral side, 4.6%+/-0.5%; p = .06), and surfactant apoprotein A (contusion side, 7177+/-1404 ng/mL; contralateral side, 4513+/-787 ng/mL, p = .10). There was no statistical difference for minimal surface tension measured with the pulsating bubble surfactometer after 5 mins of oscillation (contusion side, 29.5+/-2.3 mN/m; contralateral side, 23.7+/-2.1 mN/m; p = .08). CONCLUSIONS Direct damage of lung parenchyma by lung contusion alters the composition of surfactant. No additional changes in surfactant function were observed that would argue in favor of functional compensation.
M Aufmkolk, and
R Fischer, and
G Voggenreiter, and
C Kleinschmidt, and
K P Schmit-Neuerburg, and
U Obertacke
December 1996,
The Journal of trauma,
M Aufmkolk, and
R Fischer, and
G Voggenreiter, and
C Kleinschmidt, and
K P Schmit-Neuerburg, and
U Obertacke
January 1995,
Cahiers d'anesthesiologie,
M Aufmkolk, and
R Fischer, and
G Voggenreiter, and
C Kleinschmidt, and
K P Schmit-Neuerburg, and
U Obertacke
July 1993,
Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen,
M Aufmkolk, and
R Fischer, and
G Voggenreiter, and
C Kleinschmidt, and
K P Schmit-Neuerburg, and
U Obertacke
May 1967,
Annales de chirurgie,
M Aufmkolk, and
R Fischer, and
G Voggenreiter, and
C Kleinschmidt, and
K P Schmit-Neuerburg, and
U Obertacke
April 1993,
The Journal of trauma,
M Aufmkolk, and
R Fischer, and
G Voggenreiter, and
C Kleinschmidt, and
K P Schmit-Neuerburg, and
U Obertacke
January 1987,
Der Unfallchirurg,
M Aufmkolk, and
R Fischer, and
G Voggenreiter, and
C Kleinschmidt, and
K P Schmit-Neuerburg, and
U Obertacke
July 1991,
The Annals of thoracic surgery,
M Aufmkolk, and
R Fischer, and
G Voggenreiter, and
C Kleinschmidt, and
K P Schmit-Neuerburg, and
U Obertacke
April 1994,
The Journal of trauma,
M Aufmkolk, and
R Fischer, and
G Voggenreiter, and
C Kleinschmidt, and
K P Schmit-Neuerburg, and
U Obertacke
January 1997,
The American journal of physiology,
M Aufmkolk, and
R Fischer, and
G Voggenreiter, and
C Kleinschmidt, and
K P Schmit-Neuerburg, and
U Obertacke
October 1989,
The American review of respiratory disease,
