Beta-2-adrenoceptor agonists as inhibitors of lung vascular permeability to radiolabelled transferrin in the adult respiratory distress syndrome in man

Increased lung vascular permeability leading to increased plasma protein extravasation and accumulation (PPA) is a characteristic feature of acute lung injury. Using a previously described technique, PPA was monitored in the lungs of patients with the adult respiratory distress syndrome (ARDS)--an e...

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Bibliographic Details
Published in:European Journal of Nuclear Medicine 1986-11, Vol.12 (8), p.381-384
Main Authors: BASRAN, G. S, HARDY, J. G, WOO, S. P, RAMIAH RAMASUBRAMANIAN, BYRNE, A. J
Format: Article
Language:English
Subjects:
Adrenergic beta-Agonists - therapeutic use
Biological and medical sciences
Capillary Permeability - drug effects
Humans
Indium
Lung - diagnostic imaging
Medical sciences
Pharmacology. Drug treatments
Radioisotopes
Radionuclide Imaging
Respiratory Distress Syndrome, Adult - diagnostic imaging
Respiratory Distress Syndrome, Adult - drug therapy
Respiratory system
Terbutaline - therapeutic use
Transferrin
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Summary:Increased lung vascular permeability leading to increased plasma protein extravasation and accumulation (PPA) is a characteristic feature of acute lung injury. Using a previously described technique, PPA was monitored in the lungs of patients with the adult respiratory distress syndrome (ARDS)--an extreme example of acute lung injury in man. An external radiation probe detector was used to monitor the pulmonary accumulation of the plasma protein transferrin radiolabelled in-vivo with 113mIn. Ten patients with ARDS exhibiting increased PPA indices (greater than 1.0 x 10(-3)/min) were given an intravenous infusion of terbutaline (7 micrograms/kg) over 30 min. Of the four patients in whom the post-drug PPA indices remained within the ARDS range, none survived, whilst five of the six patients in whom the post-drug PPA indices were reduced to below 1.0 x 10(-3)/min survived. PPA indices prior to the administration of terbutaline were not significantly different between the survivor (n = 5) and non-survivor (n = 5) groups. There was a significant decrease in the PPA indices following terbutaline in survivors (p less than 0.01) but not in non-survivors. Thus beta-2-agonists in therapeutic doses can inhibit increased lung vascular permeability in man. These findings may have prognostic and therapeutic implications for beta-2-agonists in ARDS.
ISSN:0340-6997
1619-7089
DOI:10.1007/bf00252194