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Spectroscopic approach to capillary-alveolar membrane damage: RESULTS AND DISCUSSION (6)

Lung injury

Although the interstitial HES level depends on the HES level in the circulatory system, the appearance of HES in a patient’s plasma and bronchial washings exhibits a phase difference (ie, a time course difference). Generally, infused HES takes a very short time to flow into most organs in the body; however, the time for HES to infiltrate the inter-stitium from capillaries is much longer than that in the circulatory system. In addition, HES in the circulatory system has a much shorter half-life than in the interstitium, because alpha-amylases present in the tissue and in the circulation act at different rates. buy ortho tri-cyclen
This implies that measuring plasma HES concentrations and comparing that with fluid from bronchial washing might not truly represent the degree of leakage, especially when the HES concentration in the circulation is lower than in the bronchial washings. To avoid this problem, evaluation of capillary HES leakage should involve an analysis of starch in the bronchial washing fluid without necessarily correlating it with that in plasma. This means that the use of bronchial washing fluid to determine pulmonary permeability yields information on only leakage versus nonleakage. While this qualitative analysis provides solely a ‘leak’ or ‘nonleak’ answer to the problem, it is crucial for providing information on the pathophysiological changes of ALI/ARDS in a clinical setting. Furthermore, the application of pattern recognition techniques for spectral classification may provide a useful clinical index of lung injury.

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