Surfactant protein-A levels in patients with acute respiratory distress syndrome
Balamugesh, T.; Kaur, S.; Majumdar, S.; Behera, D.
Indian Journal of Medical Research 117: 129-133
2003
ISSN/ISBN: 0019-5340 PMID: 14575179 Document Number: 556750
Background & objectives: The decrease in surfactant protein-A (SP-A level) has recently been implicated in the pathophysiology of acute respiratory distress syndrome (ARDS). Mechanical ventilation is the main modality of treatment of ARDS. But information on the SP-A levels after mechanical ventilation is scanty. We therefore studied the effect of mechanical ventilation on SP-A levels in patients with ARDS. Methods: In a prospective, observational study conducted in the Respiratory Intensive Care Unit of a tertiary care hospital in north India, 13 patients with ARDS requiring mechanical ventilation were included. SP-A levels in the bronchial aspirates were serially estimated by ELISA at the start of mechanical ventilation and after 24 and after 48h. Results: The SP-A level at the start of mechanical ventilation was 3.06+-2.56 mug/ml. The levels gradually increased to 3.99+-2.39 and 6.64+-2.72 mug/ml, at 24 and 48 h respectively, and this increase was statistically significant (P<0.05). Patients having an infectious etiology had lower SP-A levels compared to those with non-infections causes. Neither the initial SP-A level nor the increase in SP-A level correlated with the improvement in lung function or duration of ventilation. Interpretation & conclusion: The present study showed a progressive increase in the SP-A levels in patients with ARDS on mechanical ventilation. Further studies are required to confirm that the increase in SP-A levels may be one of the contributors for recovery in ARDS.