Die Atemnotsyndrom-Lunge-Sequestrationsorgan für lösliches Fibrin

Summary

Multifactorial permeability disorders of the alveolo-capillary exchange membranes are one of the main pathophysiologic principles of pulmonary failure in the ARDS. Under the conditions of a generalized activation of coagulation these permeability disorders result in a leakage of circulating fibrin monomers and oligomers into the pulmonary interstitia and alveoli, even before the monomers and oligomers may precipitate intravascularly to disseminated microthrombi. Under the patho-physiologic conditions of an ARDS the lungs thus become an organ of excretion for soluble, intravascularly circulating fibrin monomers and oligomers, an organ of sequestration for soluble fibrin.

• LITERATUR

• 1 Apitz K. Pathologische Physiologie der Blutgerinnung. Kolloid Z. 85: 196 1938;
• 2 Benzer H. Oberflächenspannung in der Lunge und Schocklunge. Verh. Dtsch. Ges. inn. Med. 81: 455 1975;
• 3 Bleyl U. Pathomorphologie und Pathogenese des Atemnotsyndroms. Verh. Dtsch. Ges. Path. 55: 39 1971;
• 4 Bleyl U. Morphological diagnosis of disseminated intravascular coagulation: histologic, histochemical and electronmicroscopic studies. Seminars in Thrombosis and Hemostasis 03: 247 1977;
• 5 Bleyl U. Hämostase und Schocklunge. Verh. Dtsch. Ges. Path. 62: 39-54 1978;
• 6 Bleyl U. Die pathologische Anatomie der akuten respiratorischen Insuffizienz. In: Peter K. Akute respiratorische Insuffizienz. Springer; Berlin Heidelberg New York: 1980: 60-75.
• 7 Bleyl U, Büsing C. M. Pathogenese pulmonaler hyaliner Membranen. In: Wiemers K, Scholler K. L. (Hrsg.): Lungenveränderungen bei Langzeitbeatmung. Internat. Symposium Freiburg 1971; Thieme, Stuttgart: 1973
• 8 Bleyl U, Heilmann K, Adler D. Generalisierte plasmatische Hyperkoagulabilität und pulmonale hyaline Membranen beim Erwachsenen. Klin. Wschr. 49: 71 1971;
• 9 Bleyl U, Klar E. Der Abbau von löslichem und unlöslichem Fibrin durch das RES. In: Schimpf K. l. (Hrsg.): Fibrinogen, Fibrin und Fibrinkleber, Schattauer. Stuttgart New York; 1980: 141-155.
• 10 Bleyl U, Kuhn W, Graeff H. Reticuloendotheliale Clearance intravasaler Fibrinmonomere in der Milz. Thrombos. Diathes. haemorrh. (Stuttg) 22: 87 1969;
• 11 Bleyl U, Rieger R, Rossner J. A. Identification of soluble fibrinogen fibrin monomer complexes by non-enzymatic polymerisation in the tissue. Virchows Arch. Path. Anat. Histol. 378: 67 1978;
• 12 Bleyl U, Rossner J. A. Globular hyaline microthrombi their nature and morphogenesis. Virchows Arch. A. Path. Anat. Histol. 370: 113 1976;
• 13 Bleyl U, Sander E, Schindler T. The pathology and biology of uremic pneumonitis. Intens. Care Med. 07: 193 1981;
• 14 Bohle A, Krecke H. J, Miller F, Sitte H. Über die Natur des sogenannten Fibrinoids bei der generalisierten Shwartzmanschen Reaktion. In: Grabar P, Miescher P. (Hrsg.): Immunpathology. B. Schwabe, Basel; Stuttgart: 1959
• 15 Brass E. P, Forman W. B, Edwards R. V, Lindan O. Fibrin formation: The role of the fibrinogen fibrin complex. Thrombos. Haemostas. 36: 37 1976;
• 16 Büsing C. M, Bleyl U. Plasminogen activator activity of pulmonary vessels in shock. Thrombos. Res. 11: 285 1977;
• 17 Fung Y. C, Sobin S. S. Theory of sheet flow in the lung alveoli. J. Appl. Physiol. 26: 472-488 1969;
• 18 Fung Y. C, Sobin S. S. Pulmonary alveolar blood flow. Circulât. Res. 30: 470 1972;
• 19 Hardaway R. M. Syndroms of disseminated intravascular coagulation with special reference to shock and hemorrhage. Thomas, Springfield (Ill); 1966
• 20 Hugo R. v, Hafter R, Stemberger A, Graeff H. Complex formation of crosslinked fibrin oligomers with agarose coupled fibrinogen and fibrin. Hoppe-Seylers Z. Physiol. Chem. 358: 1359 1977;
• 21 Lasch G, Krecke H. J, RodriguezErdmann F, Sessner H. H, Schiitterle G. Verbrauchskoagulopathie (Pathogenese und Therapie). Folia Haematol. (N. F.) (Leipz) 01: 325 1961;
• 22 Lee L. Reticuloendothelial clearance of circulating fibrin in the pathogenesis of the generalized Shwartzman reaction. J. exp. Med. 115: 1065 1962;
• 23 Lee L, Prose P. H, Cohen M. H. The role of the RES in diffuse, lowgrade intravascular coagulation. Thrombos. Diathes. haemorrh. (Stuttg.) (Suppl) 20: 87 1966;
• 24 Lindquist O, Gerdin S, Saldeen T, Svensjö E. Demonstration of a permeability increasing factor in interstitial fluid from the lung following thrombin-induced pulmonary microembolism in the dog and the rat. Microvasc. Res. 10: 238 1975;
• 25 Manasse P. Über hyaline Ballen und Thromben in den Gefäßen bei akuten Infektionskrankheiten. Virchows Arch. 130: 217 1892;
• 26 Murray J. F. The Normal Lung. Saunders; Philadelphia, London, Toronto: 1976
• 27 Ratliff N. B, Wilson J. W, Mikat E, Hackel D. B. Altered leukocytes in pulmonary vessels of dogs in hemorrhagic shock. Microvasc. Res. 02: 241 1970;
• 28 Ratliff N. B, Wilson J. W, Mikat E, Hackel D. B, Graham T. C. The lung in hemorrhagic shock. Amer. J. Path. 65: 325 1971;
• 29 Rüfer R. Surfactant inhibition in vitro. XXV. International Congress of Physiological Sciences. Proceedings of the Internat. Union of Physiological Sciences. IX (Abstract) 1971
• 30 Saldeen T. Blood coagulation and related systems in the pathogenesis of acute respiratory distress. In: Beck E. A. Thromboseund Hämostaseforschung 1984. Schattauer, Stuttgart New York: 1984: 287.
• 31 Schlag G, Voigt W. H, Schnells G, Glatzl A. Die Ultrastruktur der menschlichen Lunge im Schock. I. Anaesthesist. 25: 512-521 1976;
• 32 Sherman L. A. Catabolism of fibrinogen and its derivatives. Thrombos. Haemostasis (Stuttg) 38: 809 1977;
• 33 Sherman L. A, Harwig S, Lee J. In vitro formation and in vivo clearance of fibrinogen complexes. J. Laborat. Clin. Medicine. 86: 100 1975;
• 34 Skjorten F. On the nature of hyaline micro thrombi. A light microscopical, immuno-fluorescent and ultrastructural study. Acta Pathol. Micribiol. Scand. 73: 489 1968;
• 35 Zenker K. Über intravasale Fibringerinnung bei der Thrombose. Beitr. path. Anat. 17: 448 1895;