Volutrauma Increases Exhaled Pentanal in Rats: A Potential Breath Biomarker for Ventilator-Induced Lung Injury
| Autor: | Theodora Shopova, Tobias Hüppe, Maximilian Alexander Floss, Jonas Doneit, Thomas Volk, Lukas M. Müller-Wirtz, Felix Maurer, Daniel Kiefer, Sascha Kreuer, Tobias Fink, Beate Wolf, Daniel I. Sessler |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
Ventilator-Induced Lung Injury medicine.medical_treatment Pentanal Lung injury Rats Sprague-Dawley Sevoflurane 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine 030202 anesthesiology Tidal Volume Animals Medicine Tidal volume Mechanical ventilation Aldehydes medicine.diagnostic_test business.industry Exhalation respiratory system Respiration Artificial Rats respiratory tract diseases Anesthesiology and Pain Medicine Bronchoalveolar lavage chemistry Anesthesia Anesthetics Inhalation Breathing Arterial blood business Bronchoalveolar Lavage Fluid Biomarkers 030217 neurology & neurosurgery |
| Zdroj: | Anesthesia & Analgesia. 133:263-273 |
| ISSN: | 0003-2999 |
| Popis: | Background Mechanical ventilation injures lungs, but there are currently no reliable methods for detecting early injury. We therefore evaluated whether exhaled pentanal, a lipid peroxidation product, might be a useful breath biomarker for stretch-induced lung injury in rats. Methods A total of 150 male Sprague-Dawley rats were investigated in 2 substudies. The first randomly assigned 75 rats to 7 hours of mechanical ventilation at tidal volumes of 6, 8, 12, 16, and 20 mL·kg-1. The second included 75 rats. A reference group was ventilated at a tidal volume of 6 mL·kg-1 for 10 hours 4 interventional groups were ventilated at a tidal volume of 6 mL·kg-1 for 1 hour, and then for 0.5, 1, 2, or 3 hours at a tidal volume of 16 mL.kg-1 before returning to a tidal volume of 6 mL·kg-1 for additional 6 hours. Exhaled pentanal was monitored by multicapillary column-ion mobility spectrometry. The first substudy included cytokine and leukocyte measurements in blood and bronchoalveolar fluid, histological assessment of the proportion of alveolar space, and measurements of myeloperoxidase activity in lung tissue. The second substudy included measurements of pentanal in arterial blood plasma, cytokine and leukocyte concentrations in bronchoalveolar fluid, and cleaved caspase 3 in lung tissue. Results Exhaled pentanal concentrations increased by only 0.5 ppb·h-1 (95% confidence interval [CI], 0.3-0.6) when rats were ventilated at 6 mL·kg-1. In contrast, exhaled pentanal concentrations increased substantially and roughly linearly at higher tidal volumes, up to 3.1 ppb·h-1 (95% CI, 2.3-3.8) at tidal volumes of 20 mL·kg-1. Exhaled pentanal increased at average rates between 1.0 ppb·h-1 (95% CI, 0.3-1.7) and 2.5 ppb·h-1 (95% CI, 1.4-3.6) after the onset of 16 mL·kg-1 tidal volumes and decreased rapidly by a median of 2 ppb (interquartile range [IQR], 0.9-3.2), corresponding to a 38% (IQR, 31-43) reduction when tidal volume returned to 6 mL·kg-1. Tidal volume, inspiratory pressure, and mechanical power were positively associated with pentanal exhalation. Exhaled and plasma pentanal were uncorrelated. Alveolar space decreased and inflammatory markers in bronchoalveolar lavage fluid increased in animals ventilated at high tidal volumes. Short, intermittent ventilation at high tidal volumes for up to 3 hours increased neither inflammatory markers in bronchoalveolar fluid nor the proportion of cleaved caspase 3 in lung tissue. Conclusions Exhaled pentanal is a potential biomarker for early detection of ventilator-induced lung injury in rats. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|