Improvement of pulmonary gas exchange after surfactant replacement in rats with Pneumocystis carinii pneumonia.

Infectious diseases are of great concern in intensive care health service in immunocompromized patients; especially infectious diseases of the lung. In these patients pneumocystis carinii is a major cause of pneumonia leading to severe respiratory distress (CDC Update, 1984; Walzer et al, 1974). Infectious diseases of the lung can cause an outpouring of edema fluid into the alveoli leading to disruption of the surfactant system, either by plasma proteins or by specific enzymes. It has been demonstrated in rats that pneumocystis carinii pneumonia (PCP) decreases the total amount of phospholipids in bronchoalveolar lavage (BAL) fluid whereas phospholipase activity in BAL fluid increases (Sheehan et al, 1986; Kernbaum et al, 1983). Furthermore, lung compliance also decreases in PCP (Sheehan et al, 1986). These findings suggest that in the pathophysiology of respiratory failure in PCP the pulmonary surfactant system may be involved.