Serum surfactant protein-A levels in patients with acute cardiogenic pulmonary edema and adult respiratory distress syndrome

Am J Respir Crit Care Med. 1995 Jul;152(1):307-17. doi: 10.1164/ajrccm.152.1.7599839.

Abstract

Detection of alveolo-capillary damage has important implications for treatment modalities in ventilated patients. Although surfactant protein-A (SP-A) is normally only found in appreciable amounts in the lung, we describe significantly elevated concentrations in the sera of patients with acute cardiogenic pulmonary edema (median, 250 ng/ml; range, 180 to 364; n = 10) and in those with the adult respiratory distress syndrome (ARDS) (median, 378 ng/ml; range, 215 to 1,378; n = 15) relative to healthy control subjects (median, 175 ng/ml; range, 123 to 248; n = 15) and ventilated patients with no cardiorespiratory disease (median, 169 ng/ml; range, 126 to 253; n = 6) (p < 0.01, in all cases). Serum SP-A was inversely related to blood oxygenation and to static respiratory system compliance both at the time of the patient's entry into the study (p < 0.005, rs = -0.51, n = 31; p < 0.001, rs = 0.82, n = 17; respectively) and during the course of admission (p < 0.001, rs = -0.34, n = 168; p < 0.001, rs = -0.50, n = 111; respectively). In addition, we describe in detail three cases of ARDS where lung function either improved, remained static, or deteriorated. We conclude that serum SP-A is an acute indicator of lung function and alveolo-capillary membrane injury.

Publication types

  • Case Reports
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Blood-Air Barrier / physiology*
  • Case-Control Studies
  • Drug Overdose / blood
  • Drug Overdose / therapy
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Glycoproteins / blood*
  • Humans
  • Lung Compliance / physiology
  • Male
  • Middle Aged
  • Oxygen / blood
  • Proteolipids / blood*
  • Pulmonary Edema / blood*
  • Pulmonary Edema / physiopathology
  • Pulmonary Edema / therapy
  • Pulmonary Surfactant-Associated Protein A
  • Pulmonary Surfactant-Associated Proteins
  • Pulmonary Surfactants / blood*
  • Respiration, Artificial
  • Respiratory Distress Syndrome, Adult / blood*
  • Respiratory Distress Syndrome, Adult / physiopathology
  • Respiratory Distress Syndrome, Adult / therapy

Substances

  • Glycoproteins
  • Proteolipids
  • Pulmonary Surfactant-Associated Protein A
  • Pulmonary Surfactant-Associated Proteins
  • Pulmonary Surfactants
  • Oxygen