OBJECTIVE: To evaluate the effects of different mechanical ventilation (MV) strategies on the mucociliary system. DESIGN AND SETTING: Experimental study. SUBJECTS: Twenty-seven male New Zealand rabbits. INTERVENTIONS: After anesthesia, animals were tracheotomized and ventilated with standard ventilation [tidal volume (Vt) 8 ml/kg, positive end expiratory pressure (PEEP) 5 cmH(2)O, flow 3 L/min, FiO(2) 0.4] for 30 min. Next, animals were randomized into three groups and ventilated for 3 h with low volume (LV): Vt 8 ml/kg, PEEP 5 cmH(2)O, flow 3 L/min (n = 6); high volume (HV): Vt 16 ml/kg, PEEP 5 cmH(2)O, flow 5 L/min (n = 7); or high pressure (HP): Ppeak 30 cmH(2)O, PEEP 12 cmH(2)O (n = 8). Six animals (controls) were ventilated for 10 min with standard ventilation. Vital signals, blood lactate, and respiratory system mechanics were verified. Tracheal tissue was collected before and after MV. MEASUREMENTS: Lung and tracheal tissue sections were stained to analyze inflammation and mucosubstances by the point-counting method. Electron microscopy verified tracheal cell ultrastructure. In situ tracheal ciliary beating frequency (CBF), determined using a videoscopic technique, and tracheal mucociliary transport (TMCT), assessed by stereoscopic microscope, were evaluated before and after MV. RESULTS: Respiratory compliance decreased in the HP group. The HV and HP groups showed higher lactate levels after MV. Macroscopy showed areas of atelectasis and congestion on HV and HP lungs. Lung inflammatory infiltrate increased in all ventilated groups. Compared to the control, ventilated animals also showed a reduction of total and acid mucus on tracheal epithelium. Under electron microscopy, injury was observed in the ciliated cells of the HP group. CBF decreased significantly after MV only in the HP group. TMCT did not change significantly in the ventilated groups. CONCLUSIONS: Different MV strategies induce not only distal lung alterations but also morphological and physiological tracheal alterations leading to mucociliary system dysfunction.
OBJECTIVE: To evaluate the effects of different mechanical ventilation (MV) strategies on the mucociliary system. DESIGN AND SETTING: Experimental study. SUBJECTS: Twenty-seven male New Zealand rabbits. INTERVENTIONS: After anesthesia, animals were tracheotomized and ventilated with standard ventilation [tidal volume (Vt) 8 ml/kg, positive end expiratory pressure (PEEP) 5 cmH(2)O, flow 3 L/min, FiO(2) 0.4] for 30 min. Next, animals were randomized into three groups and ventilated for 3 h with low volume (LV): Vt 8 ml/kg, PEEP 5 cmH(2)O, flow 3 L/min (n = 6); high volume (HV): Vt 16 ml/kg, PEEP 5 cmH(2)O, flow 5 L/min (n = 7); or high pressure (HP): Ppeak 30 cmH(2)O, PEEP 12 cmH(2)O (n = 8). Six animals (controls) were ventilated for 10 min with standard ventilation. Vital signals, blood lactate, and respiratory system mechanics were verified. Tracheal tissue was collected before and after MV. MEASUREMENTS: Lung and tracheal tissue sections were stained to analyze inflammation and mucosubstances by the point-counting method. Electron microscopy verified tracheal cell ultrastructure. In situ tracheal ciliary beating frequency (CBF), determined using a videoscopic technique, and tracheal mucociliary transport (TMCT), assessed by stereoscopic microscope, were evaluated before and after MV. RESULTS: Respiratory compliance decreased in the HP group. The HV and HP groups showed higher lactate levels after MV. Macroscopy showed areas of atelectasis and congestion on HV and HP lungs. Lung inflammatory infiltrate increased in all ventilated groups. Compared to the control, ventilated animals also showed a reduction of total and acid mucus on tracheal epithelium. Under electron microscopy, injury was observed in the ciliated cells of the HP group. CBF decreased significantly after MV only in the HP group. TMCT did not change significantly in the ventilated groups. CONCLUSIONS: Different MV strategies induce not only distal lung alterations but also morphological and physiological tracheal alterations leading to mucociliary system dysfunction.
Authors: Hirotoshi Matsui; Victoria E Wagner; David B Hill; Ute E Schwab; Troy D Rogers; Brian Button; Russell M Taylor; Richard Superfine; Michael Rubinstein; Barbara H Iglewski; Richard C Boucher Journal: Proc Natl Acad Sci U S A Date: 2006-11-20 Impact factor: 11.205
Authors: Rogerio Pazetti; Paulo M Pêgo-Fernandes; Geraldo Lorenzi-Filho; Paulo H N Saldiva; Luiz Felipe P Moreira; Fabio B Jatene Journal: Ann Thorac Surg Date: 2008-06 Impact factor: 4.330
Authors: Elaine Cristina Gonçalves; Hugo C D Souza; Joana Tambascio; Marcelo Barros Almeida; Anibal Basile Filho; Ada Clarice Gastaldi Journal: Intensive Care Med Date: 2015-11-10 Impact factor: 17.440
Authors: Anna Geke Algera; Luigi Pisani; Renato Carneiro de Freitas Chaves; Thiago Chaves Amorim; Thomas Cherpanath; Rogier Determann; Dave A Dongelmans; Frederique Paulus; Pieter Roel Tuinman; Paolo Pelosi; Marcelo Gama de Abreu; Marcus J Schultz; Ary Serpa Neto Journal: Ann Transl Med Date: 2018-01
Authors: Dan Waisman; Anna Faingersh; Carmit Levy; Eugene Konyukhov; Fatmi Ifat Colman Klotzman; Avi Rotschild; Amir Landesberg Journal: Intensive Care Med Date: 2011-11-22 Impact factor: 17.440
Authors: Massimo Antonelli; Marc Bonten; Jean Chastre; Giuseppe Citerio; Giorgio Conti; J Randall Curtis; Daniel De Backer; Goran Hedenstierna; Michael Joannidis; Duncan Macrae; Jordi Mancebo; Salvatore M Maggiore; Alexandre Mebazaa; Jean-Charles Preiser; Patricia Rocco; Jean-François Timsit; Jan Wernerman; Haibo Zhang Journal: Intensive Care Med Date: 2012-01-04 Impact factor: 17.440