| Autor: |
Okuma Y; Feinstein Institutes for Medical Research, Northwell Health System, Manhasset, NY, USA.; Sonoda Daiichi Hospital, Tokyo, Japan., Becker LB; Feinstein Institutes for Medical Research, Northwell Health System, Manhasset, NY, USA., Yagi T; Feinstein Institutes for Medical Research, Northwell Health System, Manhasset, NY, USA., Tanda A; Sonoda Daiichi Hospital, Tokyo, Japan., Suzuki K; Sonoda Daiichi Hospital, Tokyo, Japan., Shimoda K; Sonoda Daiichi Hospital, Tokyo, Japan., Kido G; Sonoda Daiichi Hospital, Tokyo, Japan., Kagawa Y; Sonoda Daiichi Hospital, Tokyo, Japan., Shinozaki K; Kindai University Faculty of Medicine, Osaka, Japan. |
| Abstrakt: |
Recent studies revealed that excessive supplemental oxygen, such as inhaled 100% O 2 , damages various organ functions in post-cardiac arrest (CA) patients. Optimal indicators of supplemental oxygen are therefore important to prevent hyperoxic organ injuries. In this study, we evaluated a hyperoxic pulmonary injury and assessed the association between alveolar-arterial oxygen difference (AaDO 2 ) and a degree of lung oedema. In this study, we focused on the hyperoxia-induced lung injury and its association with changes of gas-exchange parameters in post-CA rats. Rats were resuscitated from 10 min of asphyxial CA and stratified into two groups: those with inhaled 100% O 2 (CA-FiO 2 1.0) and those with 30% O 2 (CA-FiO 2 0.3). We prepared a sham surgery group for comparison (sham-FiO 2 0.3). After 2 h, animals were sacrificed, and the lung wet-to-dry (W/D) weight ratio was measured. We collected blood gas results and measured the ratio of partial pressure arterial oxygen and fraction of inspired oxygen (p/f ratio), and calculated AaDO 2 . The lung W/D ratio in the CA-FiO 2 1.0 group (5.8 ± 0.26) was higher than in the CA-FiO 2 0.3 (4.6 ± 0.42) and sham-FiO 2 0.3 groups (4.6 ± 0.38, p < 0.01). There was a significant difference in AaDO 2 between CA-FiO 2 1.0 (215 ± 49.3) and, CA-FiO 2 0.3 (36.8 ± 32.3), and sham-FiO 2 0.3 groups (49.0 ± 20.5, p < 0.01). There were also significant changes in pH and blood lactate levels in the early phase among the three groups. AaDO 2 showed the strongest correlation with W/D ratio (r = 0.9415, p < 0.0001), followed by pH (r = -0.5131, p = 0.0294) and p/f ratio (r = -0.3861, p = 0.1135). Hyperoxic injury might cause the pulmonary oedema after CA. Measuring respiratory quotient (RQ) in rodents enabled an accurate calculation for AaDO 2 at a variety level of inhaled O 2 . Given that AaDO 2 measurement is non-invasive, we therefore consider AaDO 2 to be a potentially optimal indicator of post-CA hyperoxic pulmonary injury.
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