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2009 | 63 | 1 | 93-99
Article title

Patomechanizmy uszkodzenia płuc w przebiegu wstrząsu krwotocznego

Content
Title variants
EN
Pathomechanisms of lung injury in hemorrhagic shock
Languages of publication
EN
Abstracts
EN
Hemorrhagic shock provokes a number of changes in the lungs, which may result in acute respiratory distress syndrome (ARDS). The underlying cause is a multiorgan inflammation also affecting the lungs. Inflammatory mediators involved in pathomechanisms of pulmonary damage are mainly produced in the intestine during shock-induced ischaemia. They are responsible for accumulation of inflammatory cells in the lung tissue, thickening of alveolar septa, and oedema due to increased microvascular permeability. Overexpression of adhesion molecules on pulmonary epithelial cells leads to enhanced interaction with inflammatory cells. This, in turn, accelerates epithelial apoptosis, thus causing epithelial cell dysfunction. Priming neutrophils, capable of generating respiratory burst, are characterized by prolonged survival resulting in longer duration of pulmonary inflammation. Experimental data suggest that during hemorrhagic shock, lung tissue can be protected by hypertonic (7.5%) NaCl solution, antioxidants (N-acetylcysteine, vitamin E), allopurinol, 17β-estradiol as well as neutrophil elastase inhibitor – sivelestat. Studies are being carried out with the use of surfactant protein A, nitrous oxide, and small interfering Fas-RNA in hemorrhagic shock.
PL
Podczas wstrząsu krwotocznego dochodzi w płucach do morfologicznych i czynnościowych zmian, które mogą prowadzić do ostrego zespołu niewydolności oddechowej. U podłoża tych zjawisk leży proces zapalny, rozwijający się jednoczasowo w wielu narządach, w tym również w płucach. Czynniki prozapalne odgrywające istotną rolę w patomechanizmach uszkodzenia płuc wytwarzane są głównie w niedokrwionym w czasie wstrząsu przewodzie pokarmowym. Wynikiem ich działania jest gromadzenie komórek zapalnych w tkance płucnej, pogrubienie przegród pęcherzykowych oraz obrzęk płuc na skutek wzmożonej przepuszczalności naczyń włosowatych. Z powodu zwiększonej ekspresji cząstek adhezyjnych na powierzchni komórek śródbłonka naczyń płucnych dochodzi do nasilonej interakcji z komórkami zapalnymi. Skutkuje to zaburzeniem ich funkcji i przyspieszoną apoptozą komórek nabłonkowych. Pobudzone neutrofile, zdolne do nadmiernego generowania reaktywnych form tlenu w okresie reoksygenacji, charakteryzują się dłuższą przeżywalnością, co prowadzi do wydłużenia czasu trwania procesu zapalnego w płucach. Badania doświadczalne wskazują, że do czynników działających ochronnie na tkankę płucną podczas wstrząsu krwotocznego należą hipertoniczny (7,5%) roztwór NaCl, antyoksydanty (N-acetylocysteina, witamina E), allopurynol, 17β-estradiol oraz inhibitor elastazy neutrofilowej – sivelestat. Na etapie badań doświadczalnych jest stosowanie białka A surfaktantu, podtlenku azotu oraz krótkiego interferującego RNA dla Fas.
Discipline
Publisher

Year
Volume
63
Issue
1
Pages
93-99
Physical description
Contributors
  • Zakład Podstawowych Nauk Medycznych Śląski Uniwersytet Medyczny w Katowicach
author
  • Zakład Podstawowych Nauk Medycznych SUM w Katowicach, 41-902 Bytom, ul. Piekarska 18, tel. 032 397 65 30, faxL 032 397 65 42, jjochem@poczta.onet.pl
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Document Type
article
Publication order reference
Identifiers
YADDA identifier
bwmeta1.element.psjd-fd469341-0b87-4332-864b-520792592ddf
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