Caring for the Critically Ill Patient
نویسنده
چکیده
EARLY ACUTE LUNG INJURY (ALI) IS characterizedbyneutrophiliclung inflammation,permeability,and intravascular and alveolar fibrin deposition. The proinflammatory and prothrombotic fatty acid eicosanoid derivatives of cyclooxygenase (eg, thromboxaneA2)and5-lipoxygenase(eg,leukotrieneB4)enzymesaremediatorsof these processes. The type and inflammatory activity of eicosanoids liberated during inflammation depends on the membrane phospholipid composition: omega 6 (n-6) fatty acid arachidonate yields highly reactive and inflammatory dienoic prostaglandins and series 4 leukotrienes, whereas omega-3 (n-3) fatty acids such as docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) favor production of less active and potentially anti-inflammatory trienoic prostaglandins and series 5 leukotrienes. Patients at risk of developing ALI have n-3 levels approximately 25% of normal and those with
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