Addition of 5% CO2 to Inspiratory Gas Prevents Lung Injury in an Experimental Model of Pulmonary Artery Ligation
| Autor: | Gianluca Lopez, Eleonora Scotti, Stefano Ferrero, Valentina Vaira, Alessandra Mazzucco, Elena Spinelli, Tommaso Mauri, Ines Marongiu, Michele Battistin, Osvaldo Biancolilli, Thomas Langer, Francesca Roma, Giulia Colussi, Caterina Lonati, Stefano Gatti, Antonio Pesenti, Leonardo Manesso, Lorenzo Rosso, Yu Mei Wang, Alberto Zanella |
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| Přispěvatelé: | Marongiu, I, Spinelli, E, Scotti, E, Mazzucco, A, Wang, Y, Manesso, L, Colussi, G, Biancolilli, O, Battistin, M, Langer, T, Roma, F, Lopez, G, Lonati, C, Vaira, V, Rosso, L, Ferrero, S, Gatti, S, Zanella, A, Pesenti, A, Mauri, T |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Critical Care VILI Lung injury Critical Care and Intensive Care Medicine Ischemia medicine.artery Internal medicine medicine Humans Lung inhalation CO2 inhalation Experimental model business.industry Original Articles Carbon Dioxide pulmonary perfusion CO Reperfusion Injury Pulmonary artery Cardiology Ligation business therapeutic hypercapnia |
| Zdroj: | American Journal of Respiratory and Critical Care Medicine |
| ISSN: | 1535-4970 1073-449X |
| Popis: | Rationale: Unilateral ligation of the pulmonary artery may induce lung injury through multiple mechanisms, which might be dampened by inhaled CO2. Objectives: This study aims to characterize bilateral lung injury owing to unilateral ligation of the pulmonary artery in healthy swine undergoing controlled mechanical ventilation and its prevention by 5% CO2 inhalation and to investigate relevant pathophysiological mechanisms. Methods: Sixteen healthy pigs were allocated to surgical ligation of the left pulmonary artery (ligation group), seven to surgical ligation of the left pulmonary artery and inhalation of 5% CO2 (ligation + FiCO2 5%), and six to no intervention (no ligation). Then, all animals received mechanical ventilation with Vt 10 ml/kg, positive end-expiratory pressure 5 cm H2O, respiratory rate 25 breaths/min, and FiO2 50% (±FiCO2 5%) for 48 hours or until development of severe lung injury. Measurements and Main Results: Histological, physiological, and quantitative computed tomography scan data were compared between groups to characterize lung injury. Electrical impedance tomography and immunohistochemistry analysis were performed in a subset of animals to explore mechanisms of injury. Animals from the ligation group developed bilateral lung injury as assessed by significantly higher histological score, larger increase in lung weight, poorer oxygenation, and worse respiratory mechanics compared with the ligation + FiCO2 5% group. In the ligation group, the right lung received a larger fraction of Vt and inflammation was more represented, whereas CO2 dampened both processes. Conclusions: Mechanical ventilation induces bilateral lung injury within 48 hours in healthy pigs undergoing left pulmonary artery ligation. Inhalation of 5% CO2 prevents injury, likely through decreased stress to the right lung and antiinflammatory effects. |
| Databáze: | OpenAIRE |
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