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01.03.2012 | Experimental

Effects of different tidal volumes in pulmonary and extrapulmonary lung injury with or without intraabdominal hypertension

verfasst von: Cíntia L. Santos, Lillian Moraes, Raquel S. Santos, Mariana G. Oliveira, Johnatas D. Silva, Tatiana Maron-Gutierrez, Débora S. Ornellas, Marcelo M. Morales, Vera L. Capelozzi, Nelson Jamel, Paolo Pelosi, Patricia R. M. Rocco, Cristiane S. N. B. Garcia

Erschienen in: Intensive Care Medicine | Ausgabe 3/2012

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Abstract

Purpose

We hypothesized that: (1) intraabdominal hypertension increases pulmonary inflammatory and fibrogenic responses in acute lung injury (ALI); (2) in the presence of intraabdominal hypertension, higher tidal volume reduces lung damage in extrapulmonary ALI, but not in pulmonary ALI.

Methods

Wistar rats were randomly allocated to receive Escherichia coli lipopolysaccharide intratracheally (pulmonary ALI) or intraperitoneally (extrapulmonary ALI). After 24 h, animals were randomized into subgroups without or with intraabdominal hypertension (15 mmHg) and ventilated with positive end expiratory pressure = 5 cmH₂O and tidal volume of 6 or 10 ml/kg during 1 h. Lung and chest wall mechanics, arterial blood gases, lung and distal organ histology, and interleukin (IL)-1β, IL-6, caspase-3 and type III procollagen (PCIII) mRNA expressions in lung tissue were analyzed.

Results

With intraabdominal hypertension, (1) chest-wall static elastance increased, and PCIII, IL-1β, IL-6, and caspase-3 expressions were more pronounced than in animals with normal intraabdominal pressure in both ALI groups; (2) in extrapulmonary ALI, higher tidal volume was associated with decreased atelectasis, and lower IL-6 and caspase-3 expressions; (3) in pulmonary ALI, higher tidal volume led to higher IL-6 expression; and (4) in pulmonary ALI, liver, kidney, and villi cell apoptosis was increased, but not affected by tidal volume.

Conclusions

Intraabdominal hypertension increased inflammation and fibrogenesis in the lung independent of ALI etiology. In extrapulmonary ALI associated with intraabdominal hypertension, higher tidal volume improved lung morphometry with lower inflammation in lung tissue. Conversely, in pulmonary ALI associated with intraabdominal hypertension, higher tidal volume increased IL-6 expression.

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Titel: Effects of different tidal volumes in pulmonary and extrapulmonary lung injury with or without intraabdominal hypertension
verfasst von: Cíntia L. Santos
Lillian Moraes
Raquel S. Santos
Mariana G. Oliveira
Johnatas D. Silva
Tatiana Maron-Gutierrez
Débora S. Ornellas
Marcelo M. Morales
Vera L. Capelozzi
Nelson Jamel
Paolo Pelosi
Patricia R. M. Rocco
Cristiane S. N. B. Garcia
Publikationsdatum: 01.03.2012
Verlag: Springer-Verlag
Erschienen in: Intensive Care Medicine / Ausgabe 3/2012
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-011-2451-6

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Effects of different tidal volumes in pulmonary and extrapulmonary lung injury with or without intraabdominal hypertension