Increased pulmonary alveolar-capillary permeability in patients at risk for adult respiratory distress syndrome.
Two methods for predicting adult respiratory distress syndrome (ARDS) were evaluated prospectively in a group of 81 multitrauma and sepsis patients considered at clinical high risk. A popular ARDS risk-scoring method, employing discriminant analysis equations (weighted risk criteria and oxygenation characteristics), yielded a predictive accuracy of 59% and a false-negative rate of 22%. Pulmonary alveolar-capillary permeability (PACP) was determined with a radioaerosol lung-scan technique in 23 of these 81 patients, representing a statistically similar subgroup. Lung scanning achieved a predictive accuracy of 71% (after excluding patients with unilateral pulmonary contusion) and gave no false-negatives. We propose a combination of clinical risk identification and functional determination of PACP to assess a patient's risk of developing ARDS.
D000328:Adult; D002199:Capillary Permeability; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid; D011237:Predictive Value of Tests; D011650:Pulmonary Alveoli / Q000098:blood supply*; D011877:Radionuclide Imaging; D012128:Respiratory Distress Syndrome / Q000503:physiopathology*; D012306:Risk; D013667:Technetium; D016284:Technetium Tc 99m Pentetate
D009942:Organometallic Compounds; D013667:Technetium; D004369:Pentetic Acid; D016284:Technetium Tc 99m Pentetate