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Abstract
The importance of pulmonary interaction with platelets and leukocytes in inducing
acute respiratory failure was studied in a group of 23 severely septic patients and
in a second group of 12 patients undergoing abdominal aneurysm surgery. The entrapments
of platelets and white blood cells by both groups of patients were significantly correlated.
Only the neutrophils were removed consistently by the lungs. Septic patients exhibited
severe derangements in physiological shunting (Q̇S/Q̇T), physiological dead space, pulmonary vascular resi These measures of pulmonary function
were significantly poorer than in the postoperative aneurysm patients. The thrombocytopenia
observed in both patient categories did not relate to the loss of platelets in the
lungs. The percentage of platelets or white blood cells in mixed venous blood, which
passed through the lungs and appeared in arterial blood was correlated inversely with
(Q̇S/Q̇T) in septic patients (p < 0.001) but did not correlate pulmonary function. The aneurysm
patients also showed no correlation of platelet and white blood cell entrapment with
pulmonary function (save for a surprising relation between increased platelet entrapment
and decreased physiological dead space, p < 0.05). The data substantiate a relationship
between the pulmonary entrapment of platelets or white blood cells and the hypoxia
of sepsis, but fail to relate entrapment to any other functional abnormality associated
with acute respiratory failure.
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References
- The mechanism of pulmonary damage following traumatic shock.Surg Gynecol Obstet. 1970; 130: 15
- Respiratory insufficiency syndrome: Clinical and pathological definition.J Trauma. 1973; 13: 195
- The development of pulmonary ultrastructural lesions during hemorrhagic shock.J Trauma. 1975; 15: 116
- DNA synthesis in rat aortic endothelium: Effect of bacterial endotoxin and trauma.Microvascular Res. 1974; 8: 90
- Endothelial injury induced by bacterial endotoxin: Effect of complement depletion.Europ J Clin Invest. 1975; 5: 473
- The platelet and fibrinogen reactions in pseudomonas exotoxin shock.Eur Surg Res. 1973; 5: 321
- Platelet trapping by sheep kidney and heart xenografts in the dog.J Surg Res. 1974; 17: 434
- Disseminated intravascular coagulation as a possible cause of acute respiratory failure.Surg Gynecol Obstet. 1973; 137: 419
- Physiopathologic responses of the rhesus monkey to live Escherechia coli.Surg Gynecol Obstet. 1976; 142: 893
- Pulmonary effects of E. coli endotoxin: Role of leukocytes and platelets.Ann Surg. 1972; 175: 26
- Pulmonary insufficiency, microembolism and fibrinolysis inhibition in a posttraumatic autopsy material.Acta Chir Scand. 1972; 138: 545
- Platelet response to acute hemorrhage in the dog.Acta Chir Scand Suppl. 1970; : 411
- Immediate changes in the platelet adhesiveness after hemorrhage and induced coagulation.Bull Soc Int Chir. 1968; 1: 29
- Pulmonary platelet trapping during shock and pulmonary embolism.J Surg Res. 1975; 18: 559
- Role of platelets and serotonin in acute massive pulmonary embolism.Surg Gynecol Obstet. 1973; 137: 618
- The lung in hemorrhagic shock. IV. The role of neutrophile polymorphonuclear leukocytes.Am J Pathol. 1971; 65: 325
- Prevention of post-traumatic pulmonary insufficiency.Arch Surg. 1973; 106: 386
- The role of microembolism in the production of irreversible shock.Ann Surg. 1963; 158: 685
- Role of pulmonary microembolism in the hemodynamics of endotoxin shock.Surg Gynecol Obstet. 1972; 136: 777
- Reduction of platelet serotonin and the response to pulmonary emboli.Surgery. 1971; 70: 12
- Platelet kinetics in severe acute respiratory failure.Am Rev Respir Dis. 1976; 113: 135
- Role of platelets in the acute pulmonary responses to endotoxin.J Appl Physiol. 1967; 23: 47
- Mechanisms of pulmonary injury.Am J Med. 1974; 57: 493
- Sepsis presenting as acute respiratory insufficiency.Surg Gynecol Obstet. 1974; 138: 896
- Measurement of cardiac output by thermodilution.N Engl J Med. 1975; 292: 682
- Pulmonary function and platelet-lung interaction.J Appl Physiol. 1973; 34: 697
- Canine lung uptake of plasma and platelet serotonin.Microvasc Res. 1975; 9: 230
Article info
Publication history
Accepted:
March 31,
1977
Footnotes
☆Supported in part by United States Department of the Army contract Da 17-76-C-6034 and National Institutes of Health grant 2-R01-GM17366-07-C02.
Identification
Copyright
© 1978 Published by Elsevier Inc.