Impaired pulmonary surfactant synthesis in starvation and severe nonthoracic sepsis

Abstract

1. 1. Pulmonary and airway surfactant synthesis and secretion have been compared in fed, starved, and septic rats by analysis of total phospholipid and phosphatidyl choline fractions of extracted lipid. The data are amplified by measurements of rate of incorporation and specific activity of radioactive phosphorus in these fractions. 2. 2. Both starvation and sepsis interfere with synthesis, storage, and secretion of surfactant phospholipids. 3. 3. Evidence suggests that transudation of plasma constituents into the septae and the alveoli during sepsis further inactivates existing surfactant. This is associated with an increase in the frequency of the interstitial pneumonitis characteristic of severe nonthoracic infections. 4. 4. The role of circulating microemboli and peptides originating in the site of infection has been discussed with respect to the initiation of the metabolic and pathologic changes observed. 5. 5. Preservation of surfactant metabolism requires maintenance of nutrition and ventilatory support in addition to surgical management of the septic focus.