Literature DB >> 18090363

Pulmonary morphofunctional effects of mechanical ventilation with high inspiratory air flow.

Cristiane Sousa Nascimento Baez Garcia1, Soraia Carvalho Abreu, Roberta Marques Lassance Soares, Luiz Felipe Mancilha Prota, Rogério Cruz Figueira, Marcelo Marcos Morales, Vera Luiza Capelozzi, Walter Araújo Zin, Patricia Rieken Macedo Rocco.   

Abstract

OBJECTIVE: Uncertainties about the numerous degrees of freedom in ventilator settings leave many unanswered questions about the biophysical determinants of lung injury. We investigated whether mechanical ventilation with high air flow could yield lung mechanical stress even in normal animals.
DESIGN: Prospective, randomized, controlled experimental study.
SETTING: University research laboratory.
SUBJECTS: Thirty normal male Wistar rats (180-230 g).
INTERVENTIONS: Rats were ventilated for 2 hrs with tidal volume of 10 mL/kg and either with normal inspiratory air flow (V') of 10 mL/s (F10) or high V' of 30 mL/s (F30). In the control group, animals did not undergo mechanical ventilation. Because high flow led to elevated respiratory rate (200 breaths/min) and airway peak inspiratory pressure (PIP,aw = 17 cm H2O), two additional groups were established to rule out the potential contribution of these variables: a) normal respiratory rate = 100 breaths/min and V' = 30 mL/sec; and b) PIP,aw = 17 cm H2O and V' = 10 mL/sec.
MEASUREMENTS AND MAIN RESULTS: Lung mechanics and histology (light and electron microscopy), arterial blood gas analysis, and type III procollagen messenger RNA expression in lung tissue were analyzed. Ultrastructural microscopy was similar in control and F10 groups. High air flow led to increased lung plateau and peak pressures, hypoxemia, alveolar hyperinflation and collapse, pulmonary neutrophilic infiltration, and augmented type III procollagen messenger RNA expression compared with control rats. The reduction of respiratory rate did not modify the morphofunctional behavior observed in the presence of increased air flow. Even though the increase in peak pressure yielded mechanical and histologic changes, type III procollagen messenger RNA expression remained unaltered.
CONCLUSIONS: Ventilation with high inspiratory air flow may lead to high tensile and shear stresses resulting in lung functional and morphologic compromise and elevation of type III procollagen messenger RNA expression.

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Year:  2008        PMID: 18090363     DOI: 10.1097/01.CCM.0000295309.69123.AE

Source DB:  PubMed          Journal:  Crit Care Med        ISSN: 0090-3493            Impact factor:   7.598


  15 in total

1.  Assisted ventilation modes reduce the expression of lung inflammatory and fibrogenic mediators in a model of mild acute lung injury.

Authors:  Felipe Saddy; Gisele P Oliveira; Cristiane S N B Garcia; Liliane M Nardelli; Andreia F Rzezinski; Debora S Ornellas; Marcelo M Morales; Vera L Capelozzi; Paolo Pelosi; Patricia R M Rocco
Journal:  Intensive Care Med       Date:  2010-03-24       Impact factor: 17.440

2.  Effects of frequency and inspiratory plateau pressure during recruitment manoeuvres on lung and distal organs in acute lung injury.

Authors:  Paula W Steimback; Gisele P Oliveira; Andréia F Rzezinski; Pedro L Silva; Cristiane S N B Garcia; Graziela Rangel; Marcelo M Morales; José R Lapa E Silva; Vera L Capelozzi; Paolo Pelosi; Patricia R M Rocco
Journal:  Intensive Care Med       Date:  2009-02-17       Impact factor: 17.440

Review 3.  The basics of respiratory mechanics: ventilator-derived parameters.

Authors:  Pedro Leme Silva; Patricia R M Rocco
Journal:  Ann Transl Med       Date:  2018-10

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

Authors:  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
Journal:  Intensive Care Med       Date:  2012-01-11       Impact factor: 17.440

Review 5.  Mechanical Power: A New Concept in Mechanical Ventilation.

Authors:  Robin Paudel; Christine A Trinkle; Christopher M Waters; Lauren E Robinson; Evan Cassity; Jamie L Sturgill; Richard Broaddus; Peter E Morris
Journal:  Am J Med Sci       Date:  2021-09-28       Impact factor: 2.378

6.  Ventilatory frequency during intraoperative mechanical ventilation and postoperative pulmonary complications: a hospital registry study.

Authors:  Peter Santer; Shengxing Zheng; Maximilian Hammer; Sarah Nabel; Ameeka Pannu; Yunping Li; Satya Krishna Ramachandran; Marcos F Vidal Melo; Matthias Eikermann
Journal:  Br J Anaesth       Date:  2020-03-26       Impact factor: 9.166

7.  Ventilator-Induced Lung Injury (VILI) in Acute Respiratory Distress Syndrome (ARDS): Volutrauma and Molecular Effects.

Authors:  R Carrasco Loza; G Villamizar Rodríguez; N Medel Fernández
Journal:  Open Respir Med J       Date:  2015-06-26

8.  Safety and Efficacy of Combined Extracorporeal CO2 Removal and Renal Replacement Therapy in Patients With Acute Respiratory Distress Syndrome and Acute Kidney Injury: The Pulmonary and Renal Support in Acute Respiratory Distress Syndrome Study.

Authors:  Jérôme Allardet-Servent; Matthias Castanier; Thomas Signouret; Rettinavelou Soundaravelou; Anne Lepidi; Jean-Marie Seghboyan
Journal:  Crit Care Med       Date:  2015-12       Impact factor: 7.598

Review 9.  The future of mechanical ventilation: lessons from the present and the past.

Authors:  Luciano Gattinoni; John J Marini; Francesca Collino; Giorgia Maiolo; Francesca Rapetti; Tommaso Tonetti; Francesco Vasques; Michael Quintel
Journal:  Crit Care       Date:  2017-07-12       Impact factor: 9.097

10.  Serine/threonine kinase-protein kinase B and extracellular signal-regulated kinase regulate ventilator-induced pulmonary fibrosis after bleomycin-induced acute lung injury: a prospective, controlled animal experiment.

Authors:  Li-Fu Li; Shuen-Kuei Liao; Chung-Chi Huang; Ming-Jui Hung; Deborah A Quinn
Journal:  Crit Care       Date:  2008-08-09       Impact factor: 9.097

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