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Plasma neutrophil elastase correlates with pulmonary vascular permeability: A prospective observational study in patients with pneumonia
Author(s) -
TAGAMI TAKASHI,
KUSHIMOTO SHIGEKI,
TOSA RYOICHI,
OMURA MARIKO,
YONEZAWA KOHEI,
AKIYAMA GO,
HIRAMA HISAO,
YOKOTA HIROYUKI
Publication year - 2011
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/j.1440-1843.2011.01997.x
Subject(s) - medicine , intensive care unit , pneumonia , vascular permeability , neutrophil elastase , elastase , community acquired pneumonia , gastroenterology , pneumonia severity index , inflammation , biochemistry , chemistry , enzyme
Background and objective: Little is known about plasma neutrophil elastase (PNE) levels in patients with community‐acquired pneumonia (CAP) requiring treatment in the intensive care unit (ICU) or high care unit (HCU). In addition, the influence of PNE on pulmonary vascular permeability in a clinical setting has not been investigated. The aims of this study were (i) to investigate PNE levels in patients with CAP and (ii) to explore the relationship between PNE and pulmonary vascular permeability. Methods: Fourteen consecutive CAP patients who were admitted to the HCU ( n = 8) or ICU ( n = 6) were prospectively investigated over a 6‐month period. A group of eight patients with hydrostatic pulmonary oedema without CAP served as a control group (CG). PNE levels were measured at regular intervals. The pulmonary vascular permeability index (PVPI) was monitored in all ICU and CG patients, using the PiCCO system. Results: PNE levels were higher in the CAP patients (132 (84–261) ng/mL) than in the CG patients (77 (64–107) ng/mL) ( P = 0.04), and were highest in the ICU patients (186 (75–466) ng/mL). The PVPI was higher in the ICU patients (2.85 (1.90–4.00)) than in the CG patients (1.15 (0.75–2.35)) ( P = 0.02). PNE levels correlated with PVPI in the ICU patients ( r = 0.81, P < 0.001) but there was no correlation among the CG patients ( r = 0.14, P = 0.73). Conclusions: Patients with severe CAP had high levels of PNE, which was closely correlated with PVPI. PNE may be involved in the pathogenesis of severe pneumonia.