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GENERALIZED VASCULAR PERMEABILITY AND PULMONARY FUNCTION IN PATIENTS FOLLOWING SERIOUS TRAUMA
Abstract
It has been suggested that the adult respiratory distress syndrome (ARDS) is a manifestation of a generalized vascular permeability defect. Low-level urinary albumin excretion reflects changes in systemic vascular permeability in a variety of acute inflammatory conditions including trauma. To test the hypothesis that impaired pulmonary function is associated with increased systemic vascular permeability, 44 trauma patients with Injury Severity Scores (ISS) ranging from 9 to 75 were studied over 3 days. Urinary albumin was measured from admission and expressed as the albumin/creatinine ratio (ACR). In 24 mechanically ventilated patients mean inspired oxygen/fraction (FIO2) and mean arterial oxygen tension (PO2) were used to calculate the PO2/FIO2 ratio. For each study day patients were divided into group I, mean FIO2 > 0.5; group II, mean FIO2 < 0.5; and group III, those breathing spontaneously. During the first posttrauma period the log ACR and the PO2/FIO2 ratio were inversely related (r = -0.712; p < 0.001), and the log ACR predicted PO2/FIO2 independent of ISS (p = 0.001). The log mean ACR (SD) for groups I and III were 34.0 (5.6) and 8.7 (2.9) mg/mmol, respectively (Mann Whitney p = 0.013). Following trauma, pulmonary dysfunction is associated with increased vascular permeability in remote organs.
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“VEGF expression and increased vascular permeability occur in infection,14, 35 trauma,15, 16, 36 during fetal and postnatal growth,29, 37, 38, 39 preparing for lactation,39, 40 cancer,41, 42 protein‐losing enteropathy,43 and nephrotic syndrome44, 45 (Table 1).”
From Hypoalbuminemia: Pathogenesis and Clinical Significance (2019) · cites this paper as [16]
In the citing paper
“Other sites (muscle and adipose tissue in collaboration with the liver and, possibly, the kidney12) release these solutes into the vascular compartment from where they enter the extravascular extracellular compartment (interstitium) at increased rates, also facilitated by the increased capillary permeability.4, 13, 14, 15, 16, 17”
From Hypoalbuminemia: Pathogenesis and Clinical Significance (2019) · cites this paper as [16]
In the citing paper
“Inflammation increases capillary permeability and escape of serum albumin, leading to expansion of interstitial space and increasing the distribution volume of albumin.”
From Hypoalbuminemia: Pathogenesis and Clinical Significance (2019) · cites this paper as [16]
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Metadata
- Authors
- Gosling, P., Sanghera, K., & Dickson, G.
- Affiliations
- Selly Oak Hospital (GB)
- Birmingham Accident Hospital (GB)
- Venue
- The Journal of Trauma: Injury, Infection, and Critical Care
- Published
- 1994-04
- Volume
- 36
- Issue
- 4
- Pages
- 477-481
- ISSN
- 0022-5282 (ISSN-L)
- OpenAlex
- W1972567438
- Cited by
- 97
- References
- 0
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 3 · 2022: 1 · 2021: 3 · 2020: 3 · 2019: 1 · 2018: 4 · 2017: 3 · 2016: 3 · 2015: 3 · 2014: 3 · 2012: 4
- FWCI
- 2.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Trauma: Injury, Infection, and Critical Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Trauma, Hemostasis, Coagulopathy, Resuscitation
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
- Keywords
- lung function, trauma (physical injury), acute respiratory distress syndrome, urinary albumin, albumin-creatinine ratio, mechanical ventilation, Injury Severity Score, acute inflammatory response
- MeSH terms
- Adolescent, Adult, Aged, Albuminuria, Capillary Permeability, Child, Child, Preschool, Creatinine, Female, Humans, Kidney, Kidney Function Tests, Lung, Male, Middle Aged, Pulmonary Gas Exchange, Respiratory Insufficiency, Wounds and Injuries
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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