tailieunhanh - Báo cáo y học: " Recombinant human activated protein C in acute lung injury: what is the role of bronchial circulation"

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: Recombinant human activated protein C in acute lung injury: what is the role of bronchial circulation? | Available online http content 13 1 112 Commentary Recombinant human activated protein C in acute lung injury what is the role of bronchial circulation Marc O Maybauer Daniel L Traber and Dirk M Maybauer Department of Anesthesiology The University of Texas Medical Branch and Shriners Burns Hospital at Galveston 601 Harborside Drive Galveston TX 77555-1102 USA Corresponding author Daniel L Traber dltraber@ Published 23 January 2009 This article is online at http content 13 1 112 2009 BioMed Central Ltd Critical Care 2009 13 112 doi cc7155 See related research by Waerhaug et al. http content 12 6 R146 Abstract Impairment of the protein C pathway plays a central role in the pathogenesis of sepsis. Treatment with recombinant human activated protein C rhAPC has been reported to increase survival from severe sepsis. Protein C levels also decrease markedly in acute lung injury of both septic and nonseptic origin. Low levels of protein C in acute lung injury are associated with poor clinical outcome. The present article discusses the beneficial effects of rhAPC in oleic acid-induced lung injury as well as the controversies between different animal models and the timing of drug administration. The unique bronchial circulation in ovine models seems to be responsible for the beneficial effects of rhAPC when given simultaneously to the injury. In the previous issue of Critical Care we read with great interest a report of the first experimental study of recombinant human activated protein C rhAPC in oleic acid-induced nonseptic acute lung injury ALI in sheep 1 . Impairment of the protein C pathway plays a central role in the pathogenesis of sepsis. Treatment with rhAPC has been reported to increase survival from severe sepsis 2 . The administration of rhAPC may correct the dysregulated anticoagulant mechanism and prevent propagation of thrombin generation and the formation of microvascular thrombosis. Furthermore rhAPC may .