Incorporation of radioactive labelled cholin and palmitate into lung lecithin of rabbits treated with high doses of bromcarbamides, barbiturates and diazepam

[The so-called shock lung, a disease of lung parenchyma (author's transl)]

Although the pathogenesis of the so-called shock lung is different, from the clinical point of view the syndrome is uniform. Regarding the morphology microcirculation, vascular permeability and surfactant of the lung in shock lung are discussed. The course of the alterations in lung parenchyma is uniform, independent of the different pathogenesis in a single case. Pathology and disturbtion of lung function are conform. The relation of the so-called shock lung to other diseases of lung parenchyma is discussed and finally a definition of the so-called shock-lung recommended.

Decreased dipalmitoyllecithin content found in lung specimens from patients with so-called shock-lung

Lung specimens were obtained from 9 patients with shock lung (adult respiratory distress syndrome), immediately after death, and from 8 controls. They were analysed for phospholipid content anf for fatty acid composition of sphingomyelin and lecithin. We found an elevated phospholipid content in the affected lungs but a decreased dipalmitoyllecithin fraction of total lecithin as indicated by 127% elevated content of oleic acid in lecithin. As a consequence the relation between the palmitic acid and oleic acid moiety of lecithin shifted from 2.32 in the normal lungs to 1.64 in the diseased lungs. Since the content of dipalmitoyllecithin is closely related to the function of the surfactant system we conclude, that the alteration of surfactant function, observed in patients with adult respiratory distress syndrome may be at least in part a result of an altered surfactant metabolism, but we cannot rule out, that the findings represent an epiphenomenon in shock lung.