, Volume 32, Issue 6, pp 946-947
Date: 14 Apr 2006

Bronchoalveolar levels of plasminogen activator inhibitor-1 and soluble tissue factor are sensitive and specific markers of pulmonary inflammation

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Sir: Activation of coagulation and inhibition of fibrinolysis are hallmarks of pulmonary inflammation. Changes in alveolar fibrin turnover have been reported in pneumonia [1, 2, 3] and acute respiratory distress syndrome (ARDS) [1]. Recently in Intensive Care Medicine El Sohl et al. [4] proposed plasminogen activator inhibitor (PAI)-1 as a biomarker of ARDS in patients with aspiration pneumonitis. They reported bronchoalveolar lavage fluid PAI-1 levels in 51 patients with witnessed aspiration who had a PaO2/FIO2 ratio lower than 300 mmHg for a period no less than 4 h from admission. PAI-1 antigen levels were more than five times higher in those who progressed to ARDS than in those who did not.

We recently reported procoagulant changes in the lungs during development of ventilator-associated pneumonia (VAP) [2, 5]. Non-directed lavage fluid was collected each alternate day beginning at the start of ventilation in patients expected to be ventilated longer than 3 days. All lavages were per ...