Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Inhaled activated protein C: a new therapy for the prevention of ventilator-induced lung injury? | Abraham Critical Care 2010 14 144 http content 14 2 144 CRITICAL CARE COMMENTARY L__ Inhaled activated protein C a new therapy for the prevention of ventilator-induced lung injury Edward Abraham See related research by Maniatis etal. http content 14 2 R70 Abstract Systemic administration of activated protein C APC has been shown to reduce pulmonary inflammation in preclinical models of acute lung injury. However there is only limited information concerning the effects of inhaled APC in modulating the severity of pulmonary inflammation. In a study reported in this issue of Critical Care Maniatis and colleagues show that pretreatment of mice with inhaled APC is protective against ventilator-induced lung injury. While the mechanisms responsible for this effect require additional elucidation inhaled APC appears to be a potentially useful intervention in diminishing the severity of ventilator-induced lung injury and other forms of acute lung injury. Given the multiplicity of anti-inflammatory actions of activated protein C APC it is perhaps not surprising that APC would be effective in reducing the severity of lung injury produced by the use of large tidal volumes during mechanical ventilation. In this issue of Critical Care Maniatis and colleagues 1 provide data showing that inhaled APC is protective against ventilator-induced lung injury VILI . The use of inhaled APC in these studies is an intriguing use of this agent and would be expected to target its effects to the airways and alveoli affected by VILI while minimizing systemic effects. Unfort unately the present study does not provide any information about circulating coagulation parameters or about potential leakage of the inhaled APC into the systemic circulation so it is unknown at present whether the beneficial effects found in these experiments are due purely to the pulmonary effects of APC or whether Correspondence eabraham@ Department of Medicine University of Alabama
