The DOI matches its Crossref record.
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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In the citing paper
“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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Hypoalbuminemia: Pathogenesis and Clinical Significance
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Roberts, J. A., & Lipman, J. (2009) · Critical Care Medicine · doi:10.1097/ccm.0b013e3181961bff · Cited by 861
“This capillary leak syndrome results in fluid shifts from the intravascular compartment to the interstitial space (15, 16).”
BackgroundBlot, S. I., Pea, F., & Lipman, J. (2014) · Advanced Drug Delivery Reviews · doi:10.1016/j.addr.2014.07.006 · Cited by 445
“This capillary leak is responsible for a fluid shift from the intravascular compartment to the interstitial space [37] leading to edema formation.”
BackgroundTrupka, A., Waydhas, C., Hallfeldt, K. K. J., et al. (1997) · doi:10.1097/00005373-199709000-00003 · Cited by 317
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Roberts, J. A., & Lipman, J. (2006) · Clinical Pharmacokinetics · doi:10.2165/00003088-200645080-00001 · Cited by 282
“[32] leak syndrome results in fluid shifts from the inFigure 1 schematically identifies the pharmatravascular compartment to the interstitial cokinetic changes that can occur due to the altered space,[21,22] which is known as ‘third spacing’.”
Background
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
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