Lung Injury Caused by Incorrect Strategies of Mechanical Lung Ventilation in Experimental Study
Authors:
J. Kobr 1; V. Třeška 2; J. Moláček 2; J. Kočová 3; O. Topolčan 4; J. Fremuth 1
Authors‘ workplace:
Dětská klinika, Univerzita Karlova v Praze, Lékařská fakulta v Plzni a Fakultní nemocnice, Plzeň
přednosta doc. MUDr. J. Kobr, PhD.
1; Chirurgická klinika, Univerzita Karlova v Praze, Lékařská fakulta v Plzni a Fakultní nemocnice, Plzeň
přednosta prof. MUDr. V. Třeška, DrSc.
2; Ústav histologie a embryologie, Univerzita Karlova v Praze, Lékařská fakulta v Plzni a Fakultní nemocnice, Plzeň
vedoucí doc. MUDr. J. Kočová, CSc.
3; Centrální laboratoř pro imunoanalýzu, Univerzita Karlova v Praze, Lékařská fakulta v Plzni a Fakultní nemocnice, Plzeň
vedoucí prof. MUDr. O. Topolčan, CSc.
4
Published in:
Čes-slov Pediat 2009; 64 (12): 639-647.
Category:
Original Papers
Overview
Objective:
The aim was to determine whether the incorrect strategy during 60 minutes damaged lungs and determine the possibility of influencing pulmonary venous congestion and prevent complications of artificial ventilation.
Setting:
The study was comparative, closed, randomized and double blind. The research takes place in accredited Animal Research Laboratory.
Material and methods:
With the approval of the ethics committee were enrolled in 20 domestic swine piglets, 6 weeks old, average weight 28 kg (range 26–33 kg). In general anesthesia were ventilated 60 minutes by two different strategies, and divided into 4 groups. Control Group A – VTin tidal volume 7 ml/kg, without surgery (n=4), Group B – VTin 7 ml/kg with an aortic aneurysm (n=8), Group C – VTin 14 ml/kg, aortic aneurysm, a group of D – VTin 14 ml/kg, aortic aneurysm and dopamine (n=4). In study were monitored pulmonary mechanics, preload of both heart ventricles and the quality of blood circulation. After taking lung tissue, blood, and photo the animals were killed. Lung tissue samples were histologically examined for control and serum levels of soluble adhesion molecules (CAMs).
Results:
After 60 minutes of incorrect ventilation strategy (groups C and D) were diffusion alveolar damage, decreased pulmonary dynamic compliancy (dC; p<0.05) and increased pulmonary artery pressure (PAP; p<0.01), preload of both heart ventricles (CVP; p<0.01 and PAoP; p<0.001) and plasmatic levels of soluble adhesion molecules (CAMs; p<0.05). In group D were lower CVP (p<0.05), PAoP (p<0.05) and CAMs (p<0.01).
Conclusion:
Incorrect ventilation strategy after 60 minutes damaged the lungs, reduced the quality of blood circulation and induced an inflammatory response. Dopamine decreased venous congestion and inflammatory response. Protective ventilation strategy wind did not cause complications.
Key words:
tidal volume, diffuse alveolar damage, venous congestion, inflammatory reaction
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Labels
Neonatology Paediatrics General practitioner for children and adolescentsArticle was published in
Czech-Slovak Pediatrics
2009 Issue 12
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