Does captopril decrease plasminogen activator inhibitor-1 in rats with ventilator-induced lung injury?
Mechanical ventilation with a high tidal volume and no PEEP increases alveolar fibrin deposition and systemic PAI-1 activity, which are attenuated by captopril, an angiotensin-converting enzyme inhibitor. These results imply that local ANG II is involved in the pathogenesis of disordered coagulation in ventilator-induced lung injury (VILI) and suggest that the protective mechanism of captopril's attenuation of VILI is related to a reduction in PAI-1.
Antenatally detected RPD, in isolation, is a weak predictor of VUR. Postnatal sonographic evaluation is, however, important in this group. Further investigation of infants showing moderate to severe RPD in the neonatal period is merited, as such investigation will lead to early detection of VUR in a significant number of cases (17% of RPD).