Increased lung capillary permeability after trauma: A prospective clinical study

J. A. Sturm, David H Wisner, H. J. Oestern, C. J. Kant, H. Tscherne, H. Creutzig

Research output: Contribution to journalArticle

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Abstract

Pulmonary dysfunction and permeability were prospectively studied in a group of severely traumatized patients. Ventilatory parameters (i.e., PaO2/FiO2, dynamic compliance, per cent shunt, and A-a DO2) and extravascular lung water (EVLW) measurements were compared with scintigraphic determinations of pulmonary albumin extravasation. Albumin extravasation data demonstrated a pulmonary capillary permeability increase occurring shortly following trauma. The median albumin extravasation value in the patients within 24 hours of trauma was 3.6 x 10-5/sec, compared to a control value of -0.1 ± 0.7 x 10-5/sec. Intermediate levels of albumin extravasation were found in patients studied within 48 hours of total hip replacement (1.6 ± 0.9 x 10-5/sec). Eighty per cent of patients studied within the first 48 hours of their trauma had albumin extravasation values exceeding the upper limit of normal as determined by the control value + 2 S.D. In contrast to albumin extravasation values, the PaO2/FiO2, dynamic compliance, per cent shunt, A-a DO2, and EVLW did not begin to deteriorate significantly until at least 48 hours after trauma. We conclude that severe multiple trauma induces an early increase in pulmonary capillary permeability as measured by albumin extravasation scintigraphy. This change is not detectable with other commonly used measures.

Original languageEnglish (US)
Pages (from-to)409-418
Number of pages10
JournalJournal of Trauma
Volume26
Issue number5
StatePublished - 1986

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Capillary Permeability
Albumins
Prospective Studies
Lung
Wounds and Injuries
Extravascular Lung Water
Compliance
Hip Replacement Arthroplasties
Multiple Trauma
Clinical Studies
Radionuclide Imaging
Permeability

ASJC Scopus subject areas

  • Surgery

Cite this

Sturm, J. A., Wisner, D. H., Oestern, H. J., Kant, C. J., Tscherne, H., & Creutzig, H. (1986). Increased lung capillary permeability after trauma: A prospective clinical study. Journal of Trauma, 26(5), 409-418.

Increased lung capillary permeability after trauma : A prospective clinical study. / Sturm, J. A.; Wisner, David H; Oestern, H. J.; Kant, C. J.; Tscherne, H.; Creutzig, H.

In: Journal of Trauma, Vol. 26, No. 5, 1986, p. 409-418.

Research output: Contribution to journalArticle

Sturm, JA, Wisner, DH, Oestern, HJ, Kant, CJ, Tscherne, H & Creutzig, H 1986, 'Increased lung capillary permeability after trauma: A prospective clinical study', Journal of Trauma, vol. 26, no. 5, pp. 409-418.
Sturm JA, Wisner DH, Oestern HJ, Kant CJ, Tscherne H, Creutzig H. Increased lung capillary permeability after trauma: A prospective clinical study. Journal of Trauma. 1986;26(5):409-418.
Sturm, J. A. ; Wisner, David H ; Oestern, H. J. ; Kant, C. J. ; Tscherne, H. ; Creutzig, H. / Increased lung capillary permeability after trauma : A prospective clinical study. In: Journal of Trauma. 1986 ; Vol. 26, No. 5. pp. 409-418.
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