[Efficacy of 20% albumin infusion on coagulation and pulmonary fibrosis in rabbits with ARDS].

OBJECTIVE:To observe the efficacy of 20% albumin infusion on coagulation and pulmonary fibrosis in rabbits with acute respiratory distress syndrome (ARDS) induced by two-hit of intravenous infusion of oleid acid (OA) and lipopolysaccharide (LPS). METHODS:Forty healthy adult male rabbits were randomly divided into five groups, namely sham group, model group, albumin group (20% albumin), saline group (0.9% sodium chloride injection) and Ringer group (lactate Ringer solution), with 8 rabbits in each group. ARDS model was reproduced by 0.1 mL/kg of OA and 500 μg/kg of LPS through left auricular vein, and the rabbits in sham group were intravenously infused a same volume of saline as the LPS volume given in model group. The rabbits in the three treatment groups were intravenously given corresponding drugs by micro scale pumping following LPS and OA injection through left auricular vein for 210 minutes, but no infusion was given in sham and model groups. The right internal jugular vein blood was collected, and the prothrombin time (PT), active partial prothrombin time (APTT), antithrombin III (ATIII), fibrinogen (Fib) and serum procollagen peptide III (PIIIP) levels were determined at 5, 30, 120 and 210 minutes after model reproduction respectively. Expressions of collagen I and collagen III of lung tissue were observed by immunohistochemical staining. The correlations between coagulation indexes and PIIIP levels were analyzed by partial correlation analysis. RESULTS:Compared with sham group, APTT in model animal was dynamically prolonged at 30 minutes, with a peak at the 120 minutes and then a little fall at the 210 minutes. PT had a tendency of prolongation, but no difference was found as compared with that of sham group. Fib and ATIII levels were seen to decrease gradually till 210 minutes in model group. PIIIP began to rise at 30 minutes, then decreased a little. Both the collagen I and III levels in pulmonary tissue were increasingly expressed in model rabbits. Compared with model group, the rabbits in albumin and saline groups had a similar APTT changes as that in model rabbits, but APTT in Ringer group was dynamically prolonged. PT changed more obviously in treatment groups, especially in saline group. Fib, ATIII as well as collagen I and III levels were lowered in the treatment groups, especially in albumin group [210-minute ATIII: (64.50±17.94)% vs. (85.00±18.36)%, 210-minute collagen I (A value): 0.20±0.01 vs. 0.37±0.04, collagen III (A value): 0.19±0.02 vs. 0.38±0.04, all P < 0.05]. Serum PIIIP levels in treatment groups got obviously decreased, especially in saline group [210-minute PIIIP (μg/L): 222.76±18.69 vs. 295.45±42.75, P < 0.01]. It was shown by correlation analysis that the PIIIP in model group was positively correlated with APTT (r = 0.458, P = 0.021), but they had some negative correlation in fluid treatment groups (r = -0.194, P = 0.092). CONCLUSIONS:It was shown that 20% albumin infusion are more effective to promote oxygenation improvement as compared with saline and Ringer solution in rabbits with ARDS, and obviously decrease pulmonary collagen I and III levels in lung tissue, which indicate that hypoxemia improvement maybe related with pulmonary fibrosis alleviation.