Abstract
Acute lung injury (ALI) is characterized by increased capillary permeability, interstitial and alveolar oedema, influx of circulating inflammatory cells, and formation of hyaline membranes. Vascular endothelial growth factor (VEGF) has been correlated to a favourite prognosis in ARDS in a number of investigations. VEGF plays a role in regulating vascular permeability to water and protein.
The aim of this investigation was to characterize the role of VEGF, Angiogenin, basic fibroblast growth factor (bFGF), IL-8, and TNF-alpha, lactate and pH in exhaled breath condensate (EBC) in mechanical ventilated patients with acute lung injury. For this purpose, exhaled breath condensate was collected from 30 patients with ALI at 24 to 72 hours from start of mechanical ventilation and correlated with ventilatory parameters, clinical scores, and outcome. Cytokines were measured by a cytometric bead array assay (CBA).
We observed a significant lower value of VEGF in EBC in the group with lethal outcome compared to survival group (median:32.4 pg/ml vs. 108 pg/ml in survivors.; Mann-Whitney test: p<0.0001) but no significant difference for Angiogenin, bFGF, IL-8, or TNF-alpha. In addtion EBC-lactate and EBC-pH correlated with lung injury severity indices. There was a further correlation of bFGF and IL-8 in EBC with lung injury severity indices.
We conclude that measurement of lactate, pH, bFGF, and VEGF in EBC may provide information on prognosis in ALI.
- © 2011 ERS
