Failure of aerosolised 99mTc DTPA clearance to predict outcome in patients with adult respiratory distress syndrome.
The rate of clearance of technetium-99m labelled diethylene triamine pentacetic acid (99mTc DTPA) was measured in 32 patients with adult respiratory distress syndrome to determine if a more rapid clearance rate, possibly reflecting a more severe abnormality of pulmonary function, was associated with a reduced likelihood of recovery from pulmonary failure. Although the mean rate of clearance from lung to blood (T1/2LB) of 99mTc DTPA was more rapid in the patients (T1/2LB = 29 (SEM 3.2) min than in 42 normal subjects (T1/2LB = 59 (1.8)min), there was no difference between the clearance rate in the 18 patients who recovered from respiratory failure (T1/2LB = 31 (5) min) and the 14 who died (T1/2LB = 27 (4) min). Additionally, not all patients studied had abnormally rapid clearance rates. In 12 of the 32 patients the T1/2 fell within the range for normal individuals; this was found more commonly in patients who were predisposed to develop adult respiratory distress syndrome by pancreatitis or massive blood transfusion. These data suggest that a single measurement of 99mTc DTPA clearance in patients with established respiratory failure and adult respiratory distress syndrome is of no value in assessing the likelihood of recovery from this condition.
Royston
D
D
Department of Anaesthesia, Royal Postgraduate Medical School, Hammersmith Hospital, London.
Braude
S
S
Nolop
K B
KB
D000293:Adolescent; D000328:Adult; D000336:Aerosols; D000368:Aged; D005260:Female; D006801:Humans; D008168:Lung / Q000378:metabolism*; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D009942:Organometallic Compounds / Q000493:pharmacokinetics; D004369:Pentetic Acid / Q000493:pharmacokinetics; D011379:Prognosis; D012128:Respiratory Distress Syndrome / Q000378:metabolism*; D013667:Technetium / Q000493:pharmacokinetics; D016284:Technetium Tc 99m Pentetate
D000336:Aerosols; D009942:Organometallic Compounds; D013667:Technetium; D004369:Pentetic Acid; D016284:Technetium Tc 99m Pentetate