Comparison of the effect of aminophylline and low PEEP vs. high PEEP on EGF concentration in critically ill patients with ALI/ARDS.
BACKGROUND
Acute respiratory distress syndrome (ARDS) remains a serious, often fatal, condition, despite progress in modern critical care treatment. Cytokines play important roles in the pathogenesis of the syndrome, although their roles in the evaluation and outcome have not been clearly elucidated yet.


OBJECTIVE
We tested whether serum concentration of epidermal growth factor (EGF), as one of the important inflammatory mediators, changes with time and administration of mechanical ventilation and aminophylline.


METHODS
Thirty patients [mean (SD): age = 56.6 (17.4) years] with ARDS were enrolled. After diagnosis based on inclusion and exclusion criteria, the patients were intubated and mechanically ventilated. Two hours after ventilation with definite positive end-expiratory pressure (PEEP), aminophylline with a specific dose was started. Serum samples were obtained at five time points of 0, 2, 2.5, 4 and 8 h post-starting PEEP.


RESULTS
Serum EGF concentration decreased after mechanical ventilation with PEEP (P < 0.05). The serum EGF concentrations 8 h after intervention was statistically lower in the low PEEP group than in the high PEEP group. The Acute Physiology and Chronic Health Evaluation (APACHE) Pi score and PaO2/FiO2 improved significantly after 8 h (P < 0.05).


CONCLUSIONS
Beneficial effects of mechanical ventilation and aminophylline on APACHE Pi score and PaO2/FiO2 influence serum EGF levels. These findings may have relevance to the development of multisystem organ failure.
Salari
P
P
School of Pharmacy and Pharmaceutical Sciences Research Centre, Tehran University of Medical Sciences, Tehran, Iran.
Mojtahedzadeh
M
M
Najafi
A
A
Sadraie
S
S
Bahaadini
K
K
Moharreri
M
M
Hadavand
N
N
Abdollahi
M
M
D018806:APACHE; D000628:Aminophylline / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D016638:Critical Illness; D004815:Epidermal Growth Factor / Q000097:blood* / Q000187:drug effects; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D010100:Oxygen / Q000032:analysis / Q000097:blood / Q000502:physiology; D010313:Partial Pressure; D018579:Patient Selection; D011175:Positive-Pressure Respiration / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000097:blood* / Q000188:drug therapy / Q000401:mortality; D013997:Time Factors
D000628:Aminophylline; D004815:Epidermal Growth Factor; D010100:Oxygen