نوع مقاله : مقاله پژوهشی
نویسندگان
استادیار، گروه جراحی عمومی، دانشکده پزشکی، دانشگاه علوم پزشکی، مشهد، ایران.
چکیده
کلیدواژهها
عنوان مقاله [English]
نویسندگان [English]
Objective: Inflammation plays an important role in the pathophysiology of Acute Respiratory Distress Syndrome (ARDS). Due to the mechanisms of effectiveness of Pentoxifylline in inflammatory processes and animal studies that have been performed in this field and because of the lack of human study on the effectiveness of preventive administration of pentoxifylline in patients with ARDS, the present study investigated the effects of preventive administration of pentoxifylline in trauma patients prone to ARDS.
Methods: 62 traumatic patients prone to ARDS who fullified inclusion and exclusion criteria entered the study. These patients triple blind and are randomly devided into treatment group and placebo. The preventive effect of pentoxifylline was investigated on the incidence of Acute respiratory distress syndrome in patients admitted to the Kamyab Hospital in Mashhad. The traetment group received 400 mg of pentoxifylline and the control group received placebo for one week. Before the intervention and during one week some factors were measured such as heart rate, blood pressure, respiration rate, and continuous pulse oximetry, CRP, PO2, PCO2 and PH. Finally, the obtained data were analyzed by SPSS software.
Results: Based on our results, heart rate in treatment group was significantly lower than placebo group (p<0.05). Also, PO2 level was remarkably higher in treatment group (p<0.05). Trend changes on respiratory rate (p>0.05), CRP (p>0.05), PH (p>0.05), PCO2 (p>0.05), respiration rate (p>0.05), HCO3 (p>0.05), Systolic blood pressure (p>0.05) and SPO2 (p>0.05) did not show significant differences between the two groups.
کلیدواژهها [English]
1.Ashbaugh DG, Bigelow DB, Petty TL, Levine BE. Acute respiratory distress in adults. Lancet, 1967;2(7511):319-23.
2.Heidemann S, Nair A, Bulut Y, Sapru A. Pathophysiology and Management of Acute Respiratory Distress Syndrome in Children. Pediatric Clinics of North America. 2017;64:1017-37.
3.Rubenfeld GD, Caldwell E, Peabody E, Weaver J, Martin DP, Neff M, et al. Incidence and outcomes of acute lung injury. The New England journal of medicine. 2005;353(16):1685-93.
4.Frutos-Vivar F, Nin N, Esteban A. Epidemiology of acute lung injury and acute respiratory distress syndrome. Current opinion in critical care. 2004;10(1):1-6.
5.Estenssoro E, Dubin A, Laffaire E, Canales H, Sáenz G, Moseinco M, et al. Incidence, clinical course, and outcome in 217 patients with acute respiratory distress syndrome. Critical care medicine. 2002;30(11):2450-6.
6.Zaccardelli DS, Pattishall EN. Clinical diagnostic criteria of the adult respiratory distress syndrome in the intensive care unit. Critical care medicine. 1996;24(2):247-51.
7.Kasotakis G, Stanfield B, Haines K, Vatsaas C, Alger A, Vaslef SN, et al. Acute Respiratory Distress Syndrome (ARDS) after trauma: Improving incidence, but increasing mortality. Journal of critical care. 2021;64:213-8.
8.Treggiari MM, Hudson LD, Martin DP, Weiss NS, Caldwell E, Rubenfeld G. Effect of acute lung injury and acute respiratory distress syndrome on outcome in critically ill trauma patients. Critical care medicine. 2004;32(2):327-31.
9.Ketai LH, Grum CM. C3a and adult respiratory distress syndrome after massive transfusion. Critical care medicine. 1986;14(12):1001-3.
10.Bellani G, Laffey JG, Pham T, Fan E, Brochard L, Esteban A, et al. Epidemiology, Patterns of Care, and Mortality for Patients With Acute Respiratory Distress Syndrome in Intensive Care Units in 50 Countries. Jama. 2016;315(8):788-800.
11.Bienvenu OJ, Friedman LA, Colantuoni E, Dinglas VD, Sepulveda KA, Mendez-Tellez P, et al. Psychiatric symptoms after acute respiratory distress syndrome: a 5-year longitudinal study. Intensive care medicine. 2018;44(1):38-47.
12.Siegel MD, Siemieniuk R, Parsons P, Guyatt G. Acute respiratory distress syndrome: supportive care and oxygenation in adults. Uptodate com. 2020.
13.Griffiths MJD, McAuley DF, Perkins GD, Barrett N, Blackwood B, Boyle A, et al. Guidelines on the management of acute respiratory distress syndrome. BMJ Open Respir Res. 2019;6(1):e000420.
14.Soto GJ, Kor DJ, Park PK, Hou PC, Kaufman DA, Kim M, et al. Lung Injury Prediction Score in Hospitalized Patients at Risk of Acute Respiratory Distress Syndrome. Crit Care Med. 2016;44(12):2182-91.
16.Mokra D, Mokry J. Phosphodiesterase Inhibitors in Acute Lung Injury: What Are the Perspectives? Int J Mol Sci. 2021;22(4).
17.Guerrero A. A2A Adenosine Receptor Agonists and their Potential Therapeutic Applications.
An Update. Curr Med Chem. 2018;25(30):3597-612.
18.Milne GR, Palmer TM. Anti-inflammatory and immunosuppressive effects of the A2A adenosine receptor. ScientificWorldJournal. 2011;11:320-39.
19.Deree J, Martins J, de Campos T, Putnam JG, Loomis WH, Wolf P, et al. Pentoxifylline attenuates lung injury and modulates transcription factor activity in hemorrhagic shock. J Surg Res. 2007;143(1):99-108.
20.Bajwa EK, Malhotra CK, Thompson BT, Christiani DC, Gong MN. Statin therapy as prevention against development of acute respiratory distress syndrome: an observational study. Crit Care Med. 2012;40(5):1470-7.
21.Weigelt JA, Norcross JF, Borman KR, Snyder WH, 3rd. Early steroid therapy for respiratory failure. Arch Surg. 1985;120(5):536-40.
22.Schein RM, Bergman R, Marcial EH, Schultz D, Duncan RC, Arnold PI, et al. Complement activation and corticosteroid therapy in the development of the adult respiratory distress syndrome. Chest. 1987;91(6):850-4.
23.Bone RC, Fisher CJ, Jr., Clemmer TP, Slotman GJ, Metz CA. Early methylprednisolone treatment for septic syndrome and the adult respiratory distress syndrome. Chest. 1987;92(6):1032-6.
25.Festic E, Carr GE, Cartin-Ceba R, Hinds RF, Banner-Goodspeed V, Bansal V, et al. Randomized Clinical Trial of a Combination of an Inhaled Corticosteroid and Beta Agonist in Patients at Risk of Developing the Acute Respiratory Distress Syndrome. Crit Care Med. 2017;45(5):798-805.