Early Procoagulant Shift in the Bronchoalveolar Compartment of Patients with Secondary Peritonitis

van Till, J. W. Olivier; Levi, Marcel; Bresser, Paul; Schultz, Marcus J.; Gouma, Dirk J.; Boermeester, Marja A.
November 2006
Journal of Infectious Diseases;11/1/2006, Vol. 194 Issue 9, p1331
Academic Journal
Background. In acute respiratory distress syndrome or pneumonia, a procoagulant shift is observed in bronchoalveolar lavage fluid (BALF). The effect of a primarily extrapulmonary infection on coagulation and fibrinolysis in the pulmonary compartment is unclear. Methods. In 35 patients, 87 bronchoalveolar lavages were performed on the day of operation for secondary peritonitis (day 0) and on days 2 and 3 after surgery. Two noninfectious control groups were included: subjects undergoing bronchoalveolar lavage after elective surgery (n = 8) and those undergoing long-term mechanical ventilation (n = 10). Results. In BALF from patients with peritonitis, a tissue factor (TF)/factor VIIa—mediated activation of coagulation was shown (high levels of thrombin-antithrombin complexes). Levels of fibrinolysis activators decreased rapidly after day 0, whereas levels of inhibitors increased. The net effect was reduced fibrinolysis (plasminogen activator activity). The sequential comparison of plasma levels of TF pathway inhibitor showed higher levels in patients who died (28-day mortality; P< .001). Sequential levels of TF in BALF were higher in patients with low PaO2:FiO2 ratios (<200; P = .039). Differences between patients and control subjects were more pronounced in BALF than in plasma. Conclusions. Secondary peritonitis induces an early activation of the coagulation and inhibition of fibrinolysis in the systemic and bronchoalveolar compartments, possibly via a compartmentalized response. This imbalance may be associated with reduced oxygen delivery and an adverse outcome in secondary peritonitis.


Related Articles

  • Few definitive options exist to manage acute respiratory disease. Hoskins, Johnny O. // DVM: The Newsmagazine of Veterinary Medicine;Nov2004, Vol. 35 Issue 11, p10S 

    The article presents information about some pulmonary complications in dogs. Canine acute respiratory distress syndrome (ARDS) is an acute, usually fatal, complication of a number of disease states. ARDS is recognized clinically by the development of pulmonary edema in an animal with a...

  • Recurrent Postpartum Eosinophilic Pneumonia Presenting as Acute Respiratory Distress Syndrome. Ucar, Elif Yılmazel; Araz, Omer; Yılmaz, Nafiye; Akgun, Metin // Eurasian Journal of Medicine;Dec2011, Vol. 43 Issue 3, p200 

    Eosinophilic pneumonia (EP) is a rare disease of the lung. We aimed to present atypical course of two EP cases. They were admitted to our hospital because of acute respiratory distress syndrome (ARDS) in postpartum period. Eosinophilia was detected in bronchoscopic broncho-alveolar lavage and...

  • Ex Vivo Effect of Varespladib on Secretory Phospholipase A2 Alveolar Activity in Infants with ARDS. De Luca, Daniele; Minucci, Angelo; Piastra, Marco; Cogo, Paola E.; Vendittelli, Francesca; Marzano, Laura; Gentile, Leonarda; Giardina, Bruno; Conti, Giorgio; Capoluongo, Ettore D. // PLoS ONE;Oct2012, Vol. 7 Issue 10, Special section p1 

    Background: Secretory phospholipase A2 (sPLA2) plays a pivotal role in acute respiratory distress syndrome (ARDS). This enzyme seems an interesting target to reduce surfactant catabolism and lung tissue inflammation. Varespladib is a specifically designed indolic sPLA2 inhibitor, which has shown...

  • Vaping-Associated Acute Respiratory Failure Due to Acute Lipoid Pneumonia. Dicpinigaitis, Peter V.; Trachuk, Polina; Fakier, Feizal; Teka, Mestawet; Suhrland, Mark J. // Lung;Feb2020, Vol. 198 Issue 1, p31 

    Electronic cigarettes, pens, cartridges and other devices were developed as nicotine delivery systems not requiring combustion of tobacco leaves. This technology was subsequently employed to deliver the cannabis component tetrahydrocannabinol (THC) via products often manufactured without...

  • Bronchoalveolar Activation of Coagulation and Inhibition of Fibrinolysis during Ventilator-Associated Lung Injury. Schultz, M. J.; Determann, R. M.; Royakkers, A. A. N. M.; Wolthuis, E. K.; Korevaar, J. C.; Levi, M. M. // Critical Care Research & Practice;2012, p1 

    Background and Objective. Bronchoalveolar coagulopathy is a characteristic feature of pulmonary inflammation. We compared bronchoalveolar and systemic levels of coagulation in patients who did and patients who did not develop ventilator-associated lung injury (VALI). Methods. Secondary analysis...

  • Secretory phospholipase A2 and neonatal respiratory distress: pilot study on broncho-alveolar lavage. De Luca, Daniele; Baroni, Silvia; Vento, Giovanni; Piastra, Marco; Pietrini, Domenico; Romitelli, Federica; Capoluongo, Ettore; Romagnoli, Costantino; Conti, Giorgio; Zecca, Enrico // Intensive Care Medicine;Oct2008, Vol. 34 Issue 10, p1858 

    Secretory phospholipase A2 hydrolyzes phosphoglycerides and it has been shown to be involved in alveolar inflammation and surfactant degradation. It plays an important role in acute lung injury but it has never been studied in newborn infants. We were aimed to investigate the phospholipase A2...

  • Low-level laser therapy (LLLT) acts as cAMP-elevating agent in acute respiratory distress syndrome. Lima, Flávia; Moreira, Leonardo; Villaverde, A.; Albertini, Regiane; Castro-Faria-Neto, Hugo; Aimbire, Flávio; de Lima, Flávia Mafra; Moreira, Leonardo M; Villaverde, A B; Castro-Faria-Neto, Hugo C; Aimbire, Flávio // Lasers in Medical Science;May2011, Vol. 26 Issue 3, p389 

    The aim of this work was to investigate if the low-level laser therapy (LLLT) on acute lung inflammation (ALI) induced by lipopolysaccharide (LPS) is linked to tumor necrosis factor (TNF) in alveolar macrophages (AM) from bronchoalveolar lavage fluid (BALF) of mice. LLLT has been reported to...

  • Influenza A/H1N1 Severe Pneumonia: Novel Morphocytological Findings in Bronchoalveolar Lavage. Faverio, Paola; Aliberti, Stefano; Ezekiel, Clinton; Messinesi, Grazia; Brenna, Ambrogio; Pesci, Alberto // Interdisciplinary Perspectives on Infectious Diseases;2014, p1 

    We present the results of bronchoalveolar lavage (BAL) performed in three patients with severe influenza A/H1N1 pneumonia complicated by acute respiratory distress syndrome (ARDS). Light microscopy analysis of BAL cytocentrifugates showed the presence of characteristic large, mononuclear,...

  • Sudden Intestinal Distention in a Newborn. Koehl, George; Riley Jr., Harris D. // Clinical Pediatrics;Sept1970, Vol. 9 Issue 9, p556 

    The article presents a case of a newborn infant with sudden intestinal distention. The infant's hospital course was uneventful until the 33rd day. He had established a satisfactory growth pattern on a daily intake of 135 calories/kg. and weighed 1,750 gm. Early on the 33rd day it was noted that...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics