title: Beta-2-adrenoceptor agonists as inhibitors of lung vascular permeability to radiolabelled transferrin in the adult respiratory distress syndrome in man.
abstract: Increased lung vascular permeability leading to increased plasma protein extravasation and accumulation (PPA) is a characteristic feature of acute lung injury. Using a previously described technique, PPA was monitored in the lungs of patients with the adult respiratory distress syndrome (ARDS)--an extreme example of acute lung injury in man. An external radiation probe detector was used to monitor the pulmonary accumulation of the plasma protein transferrin radiolabelled in-vivo with 113mIn. Ten patients with ARDS exhibiting increased PPA indices (greater than 1.0 x 10(-3)/min) were given an intravenous infusion of terbutaline (7 micrograms/kg) over 30 min. Of the four patients in whom the post-drug PPA indices remained within the ARDS range, none survived, whilst five of the six patients in whom the post-drug PPA indices were reduced to below 1.0 x 10(-3)/min survived. PPA indices prior to the administration of terbutaline were not significantly different between the survivor (n = 5) and non-survivor (n = 5) groups. There was a significant decrease in the PPA indices following terbutaline in survivors (p less than 0.01) but not in non-survivors. Thus beta-2-agonists in therapeutic doses can inhibit increased lung vascular permeability in man. These findings may have prognostic and therapeutic implications for beta-2-agonists in ARDS.
mesh_terms: D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D002199:Capillary Permeability / Q000187:drug effects*; D006801:Humans; D007204:Indium; D008168:Lung / Q000000981:diagnostic imaging*; D011868:Radioisotopes; D011877:Radionuclide Imaging; D012128:Respiratory Distress Syndrome / Q000000981:diagnostic imaging* / Q000188:drug therapy; D013726:Terbutaline / Q000627:therapeutic use*; D014168:Transferrin
chemical_list: D000318:Adrenergic beta-Agonists; D011868:Radioisotopes; D014168:Transferrin; D007204:Indium; D013726:Terbutaline