tailieunhanh - Báo cáo y học: "Small airway remodeling in acute respiratory distress syndrome: a study in autopsy lung tissue"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Small airway remodeling in acute respiratory distress syndrome: a study in autopsy lung tissue. | Morales et al. Critical Care 2011 15 R4 http content 15 1 R4 KS CRITICAL CARE RESEARCH Open Access Small airway remodeling in acute respiratory distress syndrome a study in autopsy lung tissue 1 1 1 1 1 1 Maina MB Morales Ruy C Pires-Neto Nicole Inforsato Tatiana Langas Luiz FF da Silva Paulo HN Saldiva Thais Mauad1 Carlos RR Carvalho2 Marcelo BP Amato2 Marisa Dolhnikoff1 Abstract Introduction Airway dysfunction in patients with the Acute Respiratory Distress Syndrome ARDS is evidenced by expiratory flow limitation and dynamic hyperinflation. These functional alterations have been attributed to closure obstruction of small airways. Airway morphological changes have been reported in experimental models of acute lung injury characterized by epithelial necrosis and denudation in distal airways. To date however no study has focused on the morphological airway changes in lungs from human subjects with ARDS. The aim of this study is to evaluate structural and inflammatory changes in distal airways in ARDS patients. Methods We retrospectively studied autopsy lung tissue from subjects who died with ARDS and from control subjects who died of non pulmonary causes. Using image analysis we quantified the extension of epithelial changes normal abnormal and denudated epithelium expressed as percentages of the total epithelium length bronchiolar inflammation airway wall thickness and extracellular matrix ECM protein content in distal airways. The Student s t-test or the Mann-Whitney test was used to compare data between the ARDS and control groups. Bonferroni adjustments were used for multiple tests. The association between morphological and clinical data was analyzed by Pearson rank test. Results Thirty-one ARDS patients A PaO2 FiO2 200 45 14 years 16 males and 11 controls C 52 16 years 7 males were included in the study. ARDS airways showed a shorter extension of normal epithelium A C P a larger extension of epithelium denudation A .