Abstract
Alcohol is the most frequently abused drug throughout the world, and alcohol-related problems are a common occurrence among patients admitted to hospitals and intensive care units (ICUs). Alcohol affects all tissues of the body. Its effects on immune function and the systemic inflammatory response syndrome (SIRS) remain topics of active investigation. In regard to immune function, alcohol consumption alters the response at several points along the inflammatory cascade. Due to these potent modulating effects on immune function, alcoholic patients have an increased incidence and severity of infection, particularly in the lung. This association between alcohol use and infection is especially evident in the post-operative setting. Among patients with sepsis, a prior history of chronic alcohol abuse confers a significant increase in the likelihood of respiratory dysfunction and development of acute respiratory distress syndrome (ARDS). Chronic alcohol abuse similarly increases the mortality from ARDS. One possible mechanism by which chronic alcohol abuse may increase susceptibility to acute lung injury (ALI) is through alterations in pulmonary glutathione homeostasis. This chapter discusses the immunomodulatory effects of alcohol and the epidemiological and experimental evidence associating chronic alcohol abuse, sepsis, and the development of ARDS.
Keywords
- Acute Lung Injury
- Acute Respiratory Distress Syndrome
- Alveolar Type
- Acute Respiratory Distress Syndrome Patient
- Epithelial Line Fluid
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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References
Lieber CS (1995) Medical disorders of alcoholism. N Engl J Med 333: 1058 - 1065
Moss M (2001) The role of alcohol in severe pneumonia and acute lung injury. In: Rello J, Leeper KV (eds) Severe Community Acquired Pneumonia. Kluwer Publishers, Boston, pp 119 - 138
Adams WL, Yuan Z, Barboriak JJ, et al (1993) Alcohol-related hospitalizations of elderly people. Prevalence and geographic variation in the United States. JAMA 270: 1222-1225
Spies C, Neuner B, Neumann T, et al (1996) Intercurrent complications in chronic alcoholic men admitted to the intensive care unit following trauma. Intensive Care Med 22: 286 - 293
Baldwin WA, Rosenfeld BA, Breslow MJ, Buchman TG, Deutschman CS, Moore RD (1993) Substance abuse-related admissions to adult intensive care. Chest 103: 21 - 25
Napolitano LM, Koruda MJ, Zimmerman K, McKowan K, Chang J, Meyer AA (1995) Chronic ethanol intake and burn injury: Evidence for synergistic alteration in gut and immune integrity. J Trauma 38: 198-207
Burch GE, DePasquale (1967) Alcoholic lung disease — an hypothesis. Am Heart J 73: 147 - 148
Bone RC, Fisher CJ, Clemmer TP, Slotman GJ, Metz CA, Balk RA (1989) Sepsis syndrome: A valid clinical entity. Methylprednisolone Severe Sepsis Study Group. Crit Care Med 17: 389-393
Mason CM, Dobard E, Kolls J, Nelson S (1998) Effect of alcohol on bacterial translocation in rats. Alcohol Clin Exp Res 22: 1640 - 1645
Nelson S, Bagby G, Summer WR (1989) Alcohol suppresses lipopolysaccharide-induced tumor necrosis factor activity in serum and lung. Life Sci 44: 673 - 676
Nelson S, Bagby G, Andreson J, Nakamura C, Shellito J, Summer W (1991) The effects of ethanol, tumor necrosis factor, and granulocyte-colony stimulating factor on lung antimicrobial defenses. Adv Exp Med Biol 288: 245 - 253
Omidvari K, Casey R, Nelson S, Olariu R, Shellito JE (1998) Alveolar macrophage release of tumor necrosis factor alpha in chronic alcoholics without liver disease. Alcohol Clin Exp Res 22: 567 - 572
Perlino CA, Rimland D (1985) Alcoholism, leukopenia, and pneumococcal sepsis. Am Rev Respir Dis 132: 757 - 760
Spagnuolo PJ, MacGregor RR (1975) Acute ethanol effect on chemotaxis and other components of host defense. J Lab Clin Med 86: 24 - 31
Coonrod JD, Lester RL, Hsu LC (1984) Characterization of the extracellular bactericidal factors of rat alveolar lining material. J Clin Invest 74: 1269 - 1279
Baughman RP, Roselle GA (1987) Surfactant deficiency with decreased opsonic activity in a guinea pig model of alcoholism. Alcohol Clin Exp Res 11: 261 - 264
Rubins JB, Charboneau D, Prigge W, Mellencamp MA (1996) Ethanol ingestion reduced anti-pneumococcal activity of rat pulmonary surfactant. J Infect Dis 174: 507 - 512
Keshavarzian A, Fields J, Vaeth J, Holmes EW (1994) The differing effects of acute and chronic alcohol on gastric and intestinal permeability. Am J Gastroenterol 89: 2205 - 2211
Rush B (1943) An inquiry into the effects of ardent spirits upon the human body and mind. Q J Stud Alcohol 4: 321 - 341
Osler W (1905) The Principles and Practices of Medicine. Appleton, New York
Saitz R, Ghali W, Moskowitz M (1997) The impact of alcohol-related diagnoses on pneumonia outcomes. Arch Intern Med 157: 1446 - 1452
Carpenter JL, Huang DY (1991) Community-acquired pulmonary infections in a public municipal hospital in the 1980s. South Med J 84: 299 - 306
Szabo G (1999) Consequences of alcohol consumption on host defense. Alcohol Alcohol 34: 830 - 841
Mufson MA, Kruss DM, Wasil RE, Metzger WI (1974) Capsular types and outcome of bacteremic pneumococcal disease in the antibiotic era. Arch Intern Med 134: 505 - 510
Fine MJ, Smith MA, Carson CA, et al (1996) Prognosis and outcomes of patients with community-acquired pneumonia: A meta-analysis. JAMA 275: 134-141
Spies CD, Kissner M, Neumann T, et al (1998) Elevated carbohydrate-deficient transferrin predicts prolonged intensive care unit stay in traumatized men. Alcohol Alcohol 33: 661669
Spies CD, Nordmann A, Brummer G, et al (1996) Intensive care unit stay is prolonged in chronic alcoholic men following resection of the upper digestive tract. Acta Anaesthesiol Scand 40: 649 - 656
Pine RW, Wertz MJ, Lennard ES, Dellinger EP, Carrico CJ, Minshew BH (1983) Determinants of organ malfunction or death in patients with intra-abdominal sepsis. A discriminant analysis. Arch Surg 118: 242-249
Jurkovich GJ, Rivara FP, Gurney JG, et al (1993) The effect of acute alcohol intoxication and chronic alcohol abuse on outcome from trauma. JAMA 270: 51 - 56
Moss M, Bucher B, Moore F, Moore EE, Parsons PE (1996) The role of chronic alcohol abuse in the development of acute respiratory distress syndrome in adults. JAMA 275: 50 - 54
Brown LA, Harris FL, Guidot DM (2001) Chronic ethanol ingestion potentiates TNF-alphamediated oxidative stress and apoptosis in rat type II cells. Am J Physiol 281: L377 - 386
Lieber CS (1993) Biochemical factors in alcoholic liver disease. Semin Liver Dis 13: 136 - 153
Holguin F, Moss I, Brown LA, Guidot GM (1998) Chronic ethanol ingestion impairs alveolar type II cell glutathione homeostasis and function and predisposes to endotoxinmediated acute edematous lung injury in rats. J Clin Invest 101: 761 - 768
Guidot DM, Modelska K, Lois M, et al (2000) Ethanol ingestion via glutathione depletion impairs alveolar epithelial barrier function in rats. Am J Physiol 279: L127 - 135
Lois M, Brown LA, Moss IM, Roman J, Guidot DM (1999) Ethanol ingestion increases activation of matrix metalloproteinases in rat lungs during acute endotoxemia. Am J Respir Crit Care Med 160: 1354 - 1360
Moss M, Guidot DM, Wong-Lambertina M, Ten Hoor T, Perez RL, Brown LA (2000) The effects of chronic alcohol abuse on pulmonary glutathione homeostasis. Am J Respir Crit Care Med 161: 414 - 419
Burnham EL, Brown LAS, Eaton S, et al (2001) Prolonged glutathione deficiency and increased total protein concentrations in epithelial lining fluid of chronic alcoholics. Am J Respir Crit Care Med 163: A816 (abst)
Eaton S, Moss IM, Martin GS (2002) Extravascular lung water correlates with oxygenation and lung injury in patients with severe sepsis. Am J Respir Crit Care Med 165: A712 (abst)
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Burnham, E.L., Moss, M., Martin, G.S. (2003). The Effect of Alcohol Consumption on Risk for Sepsis and ARDS. In: Vincent, JL. (eds) Intensive Care Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-5548-0_9
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DOI: https://doi.org/10.1007/978-1-4757-5548-0_9
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