Effects of positive end-expiratory pressure and recruitment maneuvers in a ventilator-induced injury mouse model
| Autor: | Laura A. Cagle, Lisa M. Franzi, Angela L. Linderholm, Jerold A. Last, Jason Y. Adams, Richart W. Harper, Nicholas J. Kenyon |
|---|---|
| Přispěvatelé: | Kou, Yu Ru |
| Rok vydání: | 2017 |
| Předmět: |
Pulmonology
Physiology Neutrophils medicine.medical_treatment lcsh:Medicine Pulmonary Function Lung volume reduction surgery Pulmonary compliance Pathology and Laboratory Medicine Biochemistry Diagnostic Radiology Positive-Pressure Respiration White Blood Cells Mice 0302 clinical medicine Animal Cells Immune Physiology Medicine and Health Sciences Respiratory System Procedures lcsh:Science Immune Response Acute Respiratory Distress Syndrome Lung Inbred BALB C Tidal volume Innate Immune System Mice Inbred BALB C Assistive Technology Multidisciplinary medicine.diagnostic_test Lung Volume Reduction Surgery Radiology and Imaging Respiration respiratory system Pulmonary Imaging 3. Good health Anesthesia Artificial Respiratory Breathing Cytokines Female Patient Safety Anatomy Cellular Types Bronchoalveolar Lavage Fluid Research Article Histology Imaging Techniques General Science & Technology Immune Cells Immunology Surgical and Invasive Medical Procedures Bioengineering Lung injury Research and Analysis Methods 03 medical and health sciences Signs and Symptoms Rare Diseases Diagnostic Medicine Albumins Tidal Volume medicine Animals Positive end-expiratory pressure Inflammation Mechanical ventilation Blood Cells Animal business.industry lcsh:R Biology and Life Sciences Proteins 030208 emergency & critical care medicine Cell Biology Molecular Development Respiration Artificial respiratory tract diseases Disease Models Animal Bronchoalveolar lavage 030228 respiratory system Immune System Disease Models lcsh:Q business Developmental Biology |
| Zdroj: | PloS one, vol 12, iss 11 PLoS ONE Cagle, LA; Franzi, LM; Linderholm, AL; Last, JA; Adams, JY; Harper, RW; et al.(2017). Effects of positive end-expiratory pressure and recruitment maneuvers in a ventilator-induced injury mouse model. PLoS ONE, 12(11). doi: 10.1371/journal.pone.0187419. UC Davis: Retrieved from: http://www.escholarship.org/uc/item/9448m1d8 PLoS ONE, Vol 12, Iss 11, p e0187419 (2017) |
| ISSN: | 1932-6203 |
| Popis: | Background Positive-pressure mechanical ventilation is an essential therapeutic intervention, yet it causes the clinical syndrome known as ventilator-induced lung injury. Various lung protective mechanical ventilation strategies have attempted to reduce or prevent ventilator-induced lung injury but few modalities have proven effective. A model that isolates the contribution of mechanical ventilation on the development of acute lung injury is needed to better understand biologic mechanisms that lead to ventilator-induced lung injury. Objectives To evaluate the effects of positive end-expiratory pressure and recruitment maneuvers in reducing lung injury in a ventilator-induced lung injury murine model in short- and longer-term ventilation. Methods 5–12 week-old female BALB/c mice (n = 85) were anesthetized, placed on mechanical ventilation for either 2 hrs or 4 hrs with either low tidal volume (8 ml/kg) or high tidal volume (15 ml/kg) with or without positive end-expiratory pressure and recruitment maneuvers. Results Alteration of the alveolar-capillary barrier was noted at 2 hrs of high tidal volume ventilation. Standardized histology scores, influx of bronchoalveolar lavage albumin, proinflammatory cytokines, and absolute neutrophils were significantly higher in the high-tidal volume ventilation group at 4 hours of ventilation. Application of positive end-expiratory pressure resulted in significantly decreased standardized histology scores and bronchoalveolar absolute neutrophil counts at low- and high-tidal volume ventilation, respectively. Recruitment maneuvers were essential to maintain pulmonary compliance at both 2 and 4 hrs of ventilation. Conclusions Signs of ventilator-induced lung injury are evident soon after high tidal volume ventilation (as early as 2 hours) and lung injury worsens with longer-term ventilation (4 hrs). Application of positive end-expiratory pressure and recruitment maneuvers are protective against worsening VILI across all time points. Dynamic compliance can be used guide the frequency of recruitment maneuvers to help ameloriate ventilator-induced lung injury. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|