Alveolar fluid clearance is faster in women with acute lung injury compared to men

作者：Bastarache Julie A^*; Ong Thida; Matthay Michael A; Ware Lorraine B

来源：Journal of Critical Care, 2011, 26(3): 249-256.

DOI：10.1016/j.jcrc.2010.06.005

• Gender
• Acute respiratory distress syndrome
• Mortality
• Receptor for advanced glycation end products
• Pulmonary edema

Purpose: Studies suggest that there is a sex difference in the development and outcomes of acute lung injury (ALI). Few studies have directly addressed the association of sex and alveolar fluid clearance (AFC), a process that is critical to ALI resolution.
Materials and Methods: To test the hypothesis that female sex is associated with an increased AFC rate, we measured AFC rates in 150 mechanically ventilated patients with acute pulmonary edema and a pulmonary edema fluid-to-plasma protein ratio (EF/PL) diagnostic of low permeability (EF/PL < 0.65, n = 69) or high permeability (EF/PL >= 0.65, n = 81) edema. We measured protein concentration in serial samples of undiluted EF collected within 6 hours of intubation and calculated net rate of AFC. In addition, plasma levels of receptor for advanced glycation end products were measured as a surrogate marker for alveolar epithelial injury.
Results: In patients with ALI, women had higher rates of net AFC at 4 hours compared to men (11.9% per hour vs 4.3% per hour, P = .017) and more women had maximal rates of AFC. There were no differences in circulating levels of receptor for advanced glycation end products between men and women.
Conclusions: These findings may have significant implications for future ALI studies and potential therapies. Published by Elsevier Inc.

• 出版日期2011-6