Departments of Anesthesiology and the Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA 94143, USA.
Crit Care. 2009;13(6):1011. doi: 10.1186/cc8171. Epub 2009 Dec 7.
Despite extensive research into its pathophysiology, acute lung injury/acute respiratory distress syndrome (ALI/ARDS) remains a devastating syndrome with mortality approaching 40%. Pharmacologic therapies that reduce the severity of lung injury in vivo and in vitro have not yet been translated to effective clinical treatment options, and innovative therapies are needed. Recently, the use of beta2 adrenergic agonists as potential therapy has gained considerable interest due to their ability to increase the resolution of pulmonary edema. However, the results of clinical trials of beta agonist therapy for ALI/ARDS have been conflicting in terms of benefit. In the previous issue of Critical Care, Briot and colleagues present evidence that may help clarify the inconsistent results. The authors demonstrate that, in oleic acid lung injury in dogs, the inotropic effect of beta agonists may recruit damaged pulmonary capillaries, leading to increased lung endothelial permeability.
尽管对其病理生理学进行了广泛的研究，但急性肺损伤/急性呼吸窘迫综合征（ALI/ARDS）仍然是一种毁灭性的综合征，死亡率接近 40%。在体内和体外减轻肺损伤严重程度的药物治疗尚未转化为有效的临床治疗选择，因此需要创新的治疗方法。最近，由于β2 肾上腺素能激动剂能够增加肺水肿的消退，因此作为潜在治疗方法引起了相当大的兴趣。然而，β激动剂治疗 ALI/ARDS 的临床试验结果在获益方面存在矛盾。在《危重病医学》的前一期中，Briot 及其同事提出的证据可能有助于阐明不一致的结果。作者证明，在油酸诱导的犬肺损伤中，β 激动剂的变力作用可能募集受损的肺毛细血管，导致肺内皮通透性增加。
