Albuterol for Acute Lung Injury

INTERVENTION: we will test the value of adding aerosolized albuterol sulphate 5mg dissolved in 10 ml sterile saline and nebulised by connecting the nebulizer to the endotracheal tube during mechanical ventilation of patients with acute lung injury (ALI) together with lung recruitment maneuver which is done in the form of increasing the positive end expiratory pressure (PEEP) 10 cm H2O above the lower infliction point for 15 minutes or 10 cmH2O above the pre‐recruitment PEEP to be repeated every four hours for five to seven successive days in a trial to improve alveolar fluid clearance and improve oxygenation in these patients CONDITION: we will study the effect of adding aerosolized albuterol to lung recruitment maneuver during the managment of ALI due to surgical and non‐surgical causes e.g acute lung injury following aspiration pneumonia , abdominal sepsis, pancreatitis, chest trauma , lobectomy,and so on PRIMARY OUTCOME: aveolar fluid clearance measured by protein concentration in alveolar fluid lavage in broncho‐alveolar samples will be collected just before RM. and ,1 and 4 hours after RM using A 14 –French 51 cm catheter passed through the endotracheal tube and wedged into the distal airway with contentious suction was applied to it (‐400 cm) to obtain edema fluid at least 1 ml which was collected in a sterile Eppendorf tube for immediate analysis ( Eppendorf SA, Hamburg , Germany) in the clinical pathology Lab. SECONDARY OUTCOME: mean arterial oxygen tension will be measured by arterial blood sample from the radial artery INCLUSION CRITERIA: patients with acute lung injury due to surgical and non surgical causes