BACKGROUND: Little is known about the general and local consequences of severe pneumonia under mechanical ventilation (SPMV) and how these are resolved with antibiotic therapy (ABT). OBJECTIVES: To investigate the physiologic, biological, microbiological, and pathologic changes produced by experimental SPMV in a porcine model, and to evaluate the effect of ABT. METHODS: Pseudomonas aeruginosa was inoculated in 12 large white-Landrace piglets receiving mechanical that were killed after 72 h if death did not occur before. Vital signs, serum and BAL cytokines, serum C-reactive protein (CRP), and graded postmortem lung pathology and cultures (blood and quantitative BAL and lung) were evaluated. Six piglets received inappropriate ABT (no ABT or ceftriaxone), and six piglets received appropriate ABT (ciprofloxacin). MEASUREMENTS AND MAIN RESULTS: Pathologic and microbiological evidence of infection were present in all the animals in both groups. SPMV produced significant oxygenation and lung compliance worsening, increased serum CRP, and reduced BAL fluid tumor necrosis factor (TNF)-alpha. Arterial thrombosis in lung pathology was associated with higher temperature, hypoxemia and low lung compliance, higher initial serum CRP and TNF-alpha concentrations, and increased serum interleukin (IL)-6 and BAL IL-6 and TNF-alpha. Reduced ABT reduced body temperature and culture positivity. CONCLUSIONS: This model resembles VAP and has been used for studying pulmonary infection and inflammation related to mechanical ventilation. ABT reduced fever and bacterial burden in SPMV but had no effect on cytokine or CRP concentrations, oxygenation, or lung mechanics. Pulmonary artery thrombosis was associated with worse response to infection.
BACKGROUND: Little is known about the general and local consequences of severe pneumonia under mechanical ventilation (SPMV) and how these are resolved with antibiotic therapy (ABT). OBJECTIVES: To investigate the physiologic, biological, microbiological, and pathologic changes produced by experimental SPMV in a porcine model, and to evaluate the effect of ABT. METHODS:Pseudomonas aeruginosa was inoculated in 12 large white-Landrace piglets receiving mechanical that were killed after 72 h if death did not occur before. Vital signs, serum and BAL cytokines, serum C-reactive protein (CRP), and graded postmortem lung pathology and cultures (blood and quantitative BAL and lung) were evaluated. Six piglets received inappropriate ABT (no ABT or ceftriaxone), and six piglets received appropriate ABT (ciprofloxacin). MEASUREMENTS AND MAIN RESULTS: Pathologic and microbiological evidence of infection were present in all the animals in both groups. SPMV produced significant oxygenation and lung compliance worsening, increased serum CRP, and reduced BAL fluid tumor necrosis factor (TNF)-alpha. Arterial thrombosis in lung pathology was associated with higher temperature, hypoxemia and low lung compliance, higher initial serum CRP and TNF-alpha concentrations, and increased serum interleukin (IL)-6 and BAL IL-6 and TNF-alpha. Reduced ABT reduced body temperature and culture positivity. CONCLUSIONS: This model resembles VAP and has been used for studying pulmonary infection and inflammation related to mechanical ventilation. ABT reduced fever and bacterial burden in SPMV but had no effect on cytokine or CRP concentrations, oxygenation, or lung mechanics. Pulmonary artery thrombosis was associated with worse response to infection.
Authors: Ana Motos; Joseph L Kuti; Gianluigi Li Bassi; Antoni Torres; David P Nicolau Journal: Antimicrob Agents Chemother Date: 2019-01-29 Impact factor: 5.191
Authors: Ana Motos; Gianluigi Li Bassi; Francesco Pagliara; Laia Fernandez-Barat; Hua Yang; Eli Aguilera Xiol; Tarek Senussi; Francesco A Idone; Chiara Travierso; Chiara Chiurazzi; Rosanel Amaro; Minlan Yang; Joaquim Bobi; Montserrat Rigol; David P Nicolau; Gerard Frigola; Roberto Cabrera; Jose Ramirez; Paolo Pelosi; Francesco Blasi; Massimo Antonelli; Antonio Artigas; Jordi Vila; Marin Kollef; Antoni Torres Journal: Antimicrob Agents Chemother Date: 2021-01-20 Impact factor: 5.191
Authors: Gustavo Matute-Bello; Gregory Downey; Bethany B Moore; Steve D Groshong; Michael A Matthay; Arthur S Slutsky; Wolfgang M Kuebler Journal: Am J Respir Cell Mol Biol Date: 2011-05 Impact factor: 6.914
Authors: Martin Schwienbacher; Benedikt Treml; Anna Pinna; Ralf Geiger; Hannes Reinstadler; Iris Pircher; Elisabeth Schmidl; Christian Willomitzer; Johannes Neumeister; Michael Pilch; Maria Hauer; Thomas Hager; Consolato Sergi; Sabine Scholl-Bürgi; Thomas Giese; Alexander Löckinger; Markus Nagl Journal: BMC Infect Dis Date: 2011-08-29 Impact factor: 3.090
Authors: Gianluigi Li Bassi; Laia Fernandez-Barat; Lina Saucedo; Valeria Giunta; Joan Daniel Marti; Otavio Tavares Ranzani; Eli Aguilera Xiol; Montserrat Rigol; Ignasi Roca; Laura Muñoz; Nestor Luque; Mariano Esperatti; Maria Adela Saco; Jose Ramirez; Jordi Vila; Miguel Ferrer; Antoni Torres Journal: Crit Care Date: 2015-02-27 Impact factor: 9.097
Authors: D Battaglini; A Motos; G Li Bassi; H Yang; F Pagliara; M Yang; E Aguilera Xiol; A Meli; J Bobi; G Frigola; T Senussi; F Idone; C Travierso; C Chiurazzi; L Fernandez-Barat; M Rigol; J Ramirez; P Pelosi; D Chiumello; M Antonelli; D P Nicolau; J Bringue; A Artigas; L Guerrero; D Soy; A Torres Journal: Antimicrob Agents Chemother Date: 2020-12-16 Impact factor: 5.191
Authors: Gianluigi Li Bassi; Joan Daniel Marti; Eli Aguilera Xiol; Talitha Comaru; Francesca De Rosa; Montserrat Rigol; Silvia Terraneo; Mariano Rinaudo; Laia Fernandez; Miguel Ferrer; Antoni Torres Journal: Ann Intensive Care Date: 2016-07-05 Impact factor: 6.925