BIOMAT Database Logo BIOMAT Database Logo

Increased morbidity with increased pulmonary albumin flux in sepsis-related adult respiratory distress syndrome. 1992

K Byrne, and J L Tatum, and D A Henry, and J I Hirsch, and M Crossland, and T Barnes, and J A Thompson, and J Young, and H J Sugerman
Department of Surgery, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0519.

OBJECTIVE To determine the feasibility of utilizing a scintigraphic technique to differentiate patients with adult respiratory distress syndrome due to sepsis syndrome from control volunteers and patients with congestive heart failure. Gamma scintigraphy was compared with chest roentgenograms to predict mortality rate and morbidity in adult respiratory distress syndrome (ARDS) patients. METHODS Prospective study. METHODS University hospital ICUs. METHODS Thirty-five control volunteers, 19 patients with congestive heart failure, 30 patients with a diagnosis of sepsis. RESULTS All patients were infused iv with technetium 99m-labeled albumin and underwent computerized gamma-scintigraphic analysis with a portable gamma camera. Lung-to-heart ratio of tracer was calculated and expressed as the slope index. Increase in slope index indicated increased pulmonary albumin flux. Slope index was no different in controls compared with congestive heart failure patients, unless the pulmonary artery occlusion pressure (PAOP) was greater than 30 mm Hg. Patients with a diagnosis of sepsis had an overall increased slope index compared with the other groups. A subgroup of patients in the septic group had a normal slope index. Septic patients with an increased slope index had a significantly (p less than .01) longer duration of mechanical ventilation (36 +/- 5 vs. 7 +/- 1 days), spent longer in the ICU (67 +/- 9 vs. 11 +/- 1 days), and had a longer hospital stay (113 +/- 20 vs. 35 +/- 5 days) than septic patients with a normal slope index. CONCLUSIONS Gamma scintigraphy successfully differentiated between control volunteers and patients with congestive heart failure with PAOP less than 30 mm Hg from patients with sepsis-induced ARDS. Although all of the patients with a clinical diagnosis of septic ARDS had similar impairments in oxygenation and chest roentgenograms, those patients with a significantly increased pulmonary albumin flux (greater than 2 SD above control mean) had a markedly increased morbidity.

UI MeSH Term Description Entries
D007239 Infections Invasion of the host organism by microorganisms or their toxins or by parasites that can cause pathological conditions or diseases. Infection,Infection and Infestation,Infections and Infestations,Infestation and Infection,Infestations and Infections
D007362 Intensive Care Units Hospital units providing continuous surveillance and care to acutely ill patients. ICU Intensive Care Units,Intensive Care Unit,Unit, Intensive Care
D007902 Length of Stay The period of confinement of a patient to a hospital or other health facility. Hospital Stay,Hospital Stays,Stay Length,Stay Lengths,Stay, Hospital,Stays, Hospital
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011237 Predictive Value of Tests In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test. Negative Predictive Value,Positive Predictive Value,Predictive Value Of Test,Predictive Values Of Tests,Negative Predictive Values,Positive Predictive Values,Predictive Value, Negative,Predictive Value, Positive
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D011653 Pulmonary Diffusing Capacity The amount of a gas taken up, by the pulmonary capillary blood from the alveolar gas, per minute per unit of average pressure of the gradient of the gas across the BLOOD-AIR BARRIER. Capacity, Pulmonary Diffusing,Diffusing Capacity, Pulmonary
D011859 Radiography Examination of any part of the body for diagnostic purposes by means of X-RAYS or GAMMA RAYS, recording the image on a sensitized surface (such as photographic film). Radiology, Diagnostic X-Ray,Roentgenography,X-Ray, Diagnostic,Diagnostic X-Ray,Diagnostic X-Ray Radiology,X-Ray Radiology, Diagnostic,Diagnostic X Ray,Diagnostic X Ray Radiology,Diagnostic X-Rays,Radiology, Diagnostic X Ray,X Ray Radiology, Diagnostic,X Ray, Diagnostic,X-Rays, Diagnostic

Related Publications

K Byrne, and J L Tatum, and D A Henry, and J I Hirsch, and M Crossland, and T Barnes, and J A Thompson, and J Young, and H J Sugerman
Adult respiratory distress syndrome and sepsis.
May 1993, New horizons (Baltimore, Md.),
K Byrne, and J L Tatum, and D A Henry, and J I Hirsch, and M Crossland, and T Barnes, and J A Thompson, and J Young, and H J Sugerman
Pulmonary arterial hypertension in sepsis and the adult respiratory distress syndrome.
January 1992, Acta clinica Belgica,
K Byrne, and J L Tatum, and D A Henry, and J I Hirsch, and M Crossland, and T Barnes, and J A Thompson, and J Young, and H J Sugerman
Pulmonary lactate release in patients with sepsis and the adult respiratory distress syndrome.
March 1996, Journal of critical care,
K Byrne, and J L Tatum, and D A Henry, and J I Hirsch, and M Crossland, and T Barnes, and J A Thompson, and J Young, and H J Sugerman
Early pneumococcal sepsis after pulmonary aspiration and the adult respiratory distress syndrome.
November 1983, Critical care medicine,
K Byrne, and J L Tatum, and D A Henry, and J I Hirsch, and M Crossland, and T Barnes, and J A Thompson, and J Young, and H J Sugerman
Gamma scintigraphic analysis of albumin flux in patients with acute respiratory distress syndrome.
June 1984, Surgery,
K Byrne, and J L Tatum, and D A Henry, and J I Hirsch, and M Crossland, and T Barnes, and J A Thompson, and J Young, and H J Sugerman
Adult respiratory distress syndrome: causes, morbidity, and mortality.
January 1986, Federation proceedings,
K Byrne, and J L Tatum, and D A Henry, and J I Hirsch, and M Crossland, and T Barnes, and J A Thompson, and J Young, and H J Sugerman
Pulmonary tuberculosis associated with adult respiratory distress syndrome.
December 1987, Zhonghua yi xue za zhi = Chinese medical journal; Free China ed,
K Byrne, and J L Tatum, and D A Henry, and J I Hirsch, and M Crossland, and T Barnes, and J A Thompson, and J Young, and H J Sugerman
[Adult respiratory distress syndrome caused by Listeria sepsis].
April 1980, Revista clinica espanola,
K Byrne, and J L Tatum, and D A Henry, and J I Hirsch, and M Crossland, and T Barnes, and J A Thompson, and J Young, and H J Sugerman
Pulmonary edema in adult respiratory distress syndrome.
January 1985, Survey and synthesis of pathology research,
K Byrne, and J L Tatum, and D A Henry, and J I Hirsch, and M Crossland, and T Barnes, and J A Thompson, and J Young, and H J Sugerman
Transfusion-related adult respiratory distress syndrome.
May 1993, Israel journal of medical sciences,
Copied contents to your clipboard!