Effect Of Inhaled Aerosolized Lidocaine On Surfactant-associated Protein-A In Bronchoalveolar Lavage Fluid Of ARDS

Objective:To study Effect of inhaled aerosolized lidocaine on surfactant-associated protein-A in bronchoalveolar lavage fluid of ARDS.Methods:Twenty-two patients suffered from acute respiratory distress syndrome were divided into two groups randomly:Lidocaine group(group I) and normal saline group(groupⅡ). After twenty-two patients were enrolled, We treated primary disease positively. A lung-protective ventilation strategy and a conservative strategy of fluid management should be implemented. Sedation and analgesia were implemented with midazolam and fentanyl. In group I, patients Inhaled aerosolized lidocaine(4mg/kg),which were diluted into 20ml with normal saline. In groupⅡ, patients Inhaled aerosolized normal saline, the volume of which were equal to groupⅠ.All the patients were treated continuously for six days. On the first and seventh day, they were subject to bronchoalveolar lavage. Collect the bronchoalveolar lavage fluid(BALF) and measure the concentration of SPA and TNF-a of BALF. Measure lung compliance,oxygenation index and lung injury score.Results:There were no significant difference in age,gender,body weight and primary disease which caused ARDS between two groups.There were no significant difference in concentration of SP-A and TNF-a of BALF,lung compliance,oxygenation index and lung injury score on the first day between two groups. The concentration of SP-A and TNF-αof BALF were decreased in group I compared with groupⅡ;Lung compliance and oxygenation index were increased in group I compared with groupⅡ; lung injury score were decreased in group I compared with groupⅡ.Conclusion:Inhaled aerosolized lidocaine inhibit expression down regulation of SP-A of ARDS, improve Lung compliance and oxygenation index, decrease lung injury score, which were due to inhibit the inflammatory reaction of lung.