Leukotrienes and alpha tumor necrosis factor levels in the bronchoalveolar lavage fluid of patient at risk for the adult respiratory distress syndrome.
OBJECTIVE
To examine bronchoalveolar lavage (BAL) fluid of patients at risk for Adult Respiratory Distress Syndrome in the attempt to provide evidence of an increased local production of Leukotrienes (LTS) and Tumor Necrosis Factor (TNF).


METHODS
Prospective, comparative, clinical study.


METHODS
ICU in a university hospital.


METHODS
14 patients at risk for ARDS and 10 control patients undergoing mechanical ventilation, were studied.


METHODS
BAL was performed in each patient at the time admission to the ICU (T0), and after 48 hours (T1).


RESULTS
Our controls never showed levels of TNF > 10 pg/ml and their LTS amounts were always below the detection limit. All patients at risk had levels of TNF ranging between 22 and 130 pg/ml, but no difference was noticed between patients who developed ARDS and those who did not, between survivors and non survivors, and between septic and non septic patients. LTD4 and LTB4 (ranging between 30 to 1365 pg/ml) were detected only in six of the 14 patients. Among these 6 patients, 4 developed ARDS. In these patients we could correlate LTB4 with TNF levels and the number of neutrophils recovered from the BAL fluid.


CONCLUSIONS
In our patients leukotrienes and TNF in the BAL fluid correlate well with the acute inflammatory phase of ARDS, as reflected by the increase number of leukocytes in the fluid retrieved, but they do not appear to be clearly predictive index for the syndrome.
Antonelli
M
M
Institute of Anaesthesiology and Intensive Care, La Sapienza University of Rome, Italy.
Raponi
G
G
Lenti
L
L
Severi
L
L
Capelli
O
O
Riccioni
L
L
De Blasi
R A
RA
Conti
G
G
Mancini
C
C
D000328:Adult; D000368:Aged; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry* / Q000166:cytology; D006801:Humans; D007958:Leukocyte Count; D015289:Leukotrienes / Q000032:analysis*; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications; D011446:Prospective Studies; D011654:Pulmonary Edema / Q000209:etiology / Q000378:metabolism / Q000401:mortality; D012128:Respiratory Distress Syndrome / Q000209:etiology* / Q000378:metabolism / Q000401:mortality; D018805:Sepsis / Q000150:complications; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
D015289:Leukotrienes; D014409:Tumor Necrosis Factor-alpha