Scintigraphy for Pulmonary Capillary Protein Leak

摘要

Computerized scintigraphy, employing the gamma camera, has been used to study the dynamics of the pulmonary capillary membrane leak of 99m Technetium-tagged human serum albumin (Tc-HSA). In preliminary canine studies, the severity of an oleic acid-induced albumin leak was proportional to the slope of lung: heart radioactivity ratio and was more sensitive than arterial blood gases or standard chest roentgenograms. This rising ratio is called slope of injury slope index. We studied a number of agents in an attempt to prevent oleic acid-induced pulmonary microvascular injury. Following a series of five control dogs, five dogs each were studied with each of the following agents: methylprednisolone, ibuprofen, the superoxide radical scavenger, MK-44, and, in three dogs, calcium gluconate. None of these agents was able to alter the rise in lung: heart radioactivity ratio following oleic acid injury. A septic pig model was developed for study of bacterially induced ARDS. Septic-induced ARDS and multi-system organ failure are probably secondary to the systemic release of several mediators of inflammation, treatment will probably require a combination of anti-inflammatory agents. This should impact significantly on the mortality and morbidity of septic complications in traumatized combat soldiers.