Surfactant protein-A levels in patients with acute respiratory distress syndrome.
OBJECTIVE
The decrease in surfactant protein-A (SP-A level) has recently been implicated in the pathophysiology of acute respiratory distress syndrome (ARDS). Mechanical ventilation is the main modality of treatment of ARDS. But information on the SP-A levels after mechanical ventilation is scanty. We therefore studied the effect of mechanical ventilation on SP-A levels in patients with ARDS.


METHODS
In a prospective, observational study conducted in the Respiratory Intensive Care Unit of a tertiary care hospital in north India, 13 patients with ARDS requiring mechanical ventilation were included. SP-A levels in the bronchial aspirates were serially estimated by ELISA at the start of mechanical ventilation and after 24 and after 48 h.


RESULTS
The SP-A level at the start of mechanical ventilation was 3.06 +/- 2.56 microg/ml. The levels gradually increased to 3.99 +/- 2.39 and 6.64 +/- 2.72 microg/ml, at 24 and 48 h respectively, and this increase was statistically significant (P < 0.05). Patients having an infectious etiology had lower SP-A levels compared to those with non-infections causes. Neither the initial SP-A level nor the increase in SP-A level correlated with the improvement in lung function or duration of ventilation.


CONCLUSIONS
The present study showed a progressive increase in the SP-A levels in patients with ARDS on mechanical ventilation. Further studies are required to confirm that the increase in SP-A levels may be one of the contributors for recovery in ARDS.
Balamugesh
T
T
Department of Pulmonary Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
Kaur
S
S
Majumdar
S
S
Behera
D
D
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001980:Bronchi; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008168:Lung / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000235:genetics; D011446:Prospective Studies; D037662:Pulmonary Surfactant-Associated Protein A / Q000378:metabolism*; D012128:Respiratory Distress Syndrome / Q000378:metabolism*
D037662:Pulmonary Surfactant-Associated Protein A