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Spectroscopic approach to capillary-alveolar membrane damage induced acute lung injury (3)

Lung injury

Clearly, a better procedure is warranted to diagnose ALI/ARDS effectively, and this procedure should be minimally invasive and cause little trauma to these already critically ill patients. In this paper, we introduce a new approach to detect pulmonary edema induced by increasing capillary-alveolar permeability in ALI. The approach is based on infrared (IR) spectroscopy, a technique used for the clinical diagnosis of diseased tissues and biofluids , in combination with the administration of hydroxyethyl starch (HES). The IR spectroscopic assessment of pulmonary permeability in ALI/ARDS patients does rely on the determination of PEN-TASPAN (Du Pont Pharma, Mississauga, Ontario), which is a low molecular weight HES infiltrating the alveolar space. PENTASPAN is a substituted glucose polymer with an average molecular weight of 200 to 300 kDa. Clinically, HES is used primarily as a colloid plasma volume expander. In the normal situation, the size of infused HES largely confines these molecules to the intravascular space until they are hydrolyzed by serum alpha-amylases into subunits small enough to be filtered and eliminated by the kidney . Certain pathological conditions capable of producing an increase in capillary permeability are expected to allow the larger HES macromolecules to leak into the interstitial space, and even enter the alveolar space in severe damage. The detection of HES in patient’s lung fluid thus indicates the presence of pulmonary vascular leakage, and HES can be used as an intravascular tracer of increased pulmonary capillary permeability. These HES polymers have a unique IR absorption signature that can be recognized easily and monitored by IR spectroscopy. ventolin inhaler

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