• acute lung injury;
  • acute respiratory distress syndrome;
  • aminophylline;
  • APACHE Π score;
  • epidermal growth factor


Background:  Acute respiratory distress syndrome (ARDS) remains a serious, often fatal, condition, despite progress in modern critical care treatment. Cytokines play important roles in the pathogenesis of the syndrome, although their roles in the evaluation and outcome have not been clearly elucidated yet.

Objectives:  We tested whether serum concentration of epidermal growth factor (EGF), as one of the important inflammatory mediators, changes with time and administration of mechanical ventilation and aminophylline.

Patients and methods:  Thirty patients [mean (SD): age = 56·6 (17·4) years] with ARDS were enrolled. After diagnosis based on inclusion and exclusion criteria, the patients were intubated and mechanically ventilated. Two hours after ventilation with definite positive end-expiratory pressure (PEEP), aminophylline with a specific dose was started. Serum samples were obtained at five time points of 0, 2, 2·5, 4 and 8 h post-starting PEEP.

Results:  Serum EGF concentration decreased after mechanical ventilation with PEEP (P < 0·05). The serum EGF concentrations 8 h after intervention was statistically lower in the low PEEP group than in the high PEEP group. The Acute Physiology and Chronic Health Evaluation (APACHE) Π score and PaO2/FiO2 improved significantly after 8 h (P < 0·05).

Conclusion:  Beneficial effects of mechanical ventilation and aminophylline on APACHE Π score and PaO2/FiO2 influence serum EGF levels. These findings may have relevance to the development of multisystem organ failure.