PURPOSE: Lung tissue may exhibit a biochemical response to excessive deformation. Since strain has been proposed as a marker of such deformation, we studied the relationships between strain and matrix remodeling and inflammation markers in mechanically ventilated patients with and without acute lung injury (ALI). METHODS: Twenty-two ventilated patients were studied (16 with ALI, 6 controls). Clinical data, gas exchange and respiratory mechanics were recorded, and end-expiratory lung volume (EELV) was measured by oxygen washin/washout. Extracellular matrix remodeling markers (procollagen, matrix metalloproteinases -2 and -9, TIMP-1) and inflammation markers (IL-6, IL-8, IL-10, IFNγ, IL-17A, and VEGF) were measured in bronchoalveolar lavage fluid (BALF). Strain was computed as the ratio between tidal volume and EELV. Patients with ALI were divided into two subgroups according to the median strain value (0.27). RESULTS: Patients in the ALI group exhibited higher airway pressures, lower EELV and higher strain than the control group. There were no significant differences in gas exchange, respiratory mechanics, or the matrix remodeling markers between ALI patients with normal and high strain. The subgroup of patients with high strain showed a fourfold increase of IL-6 and IL-8 concentrations in BALF, compared with patients with ALI and normal strain or patients without ALI. In the whole sample, IL-6 and IL-8 concentrations in BALF were correlated with strain (Spearman's ρ = 0.67 and 0.77, respectively). CONCLUSIONS: Increased strain is associated with a proinflammatory lung response in patients with ALI.
PURPOSE: Lung tissue may exhibit a biochemical response to excessive deformation. Since strain has been proposed as a marker of such deformation, we studied the relationships between strain and matrix remodeling and inflammation markers in mechanically ventilated patients with and without acute lung injury (ALI). METHODS: Twenty-two ventilated patients were studied (16 with ALI, 6 controls). Clinical data, gas exchange and respiratory mechanics were recorded, and end-expiratory lung volume (EELV) was measured by oxygen washin/washout. Extracellular matrix remodeling markers (procollagen, matrix metalloproteinases -2 and -9, TIMP-1) and inflammation markers (IL-6, IL-8, IL-10, IFNγ, IL-17A, and VEGF) were measured in bronchoalveolar lavage fluid (BALF). Strain was computed as the ratio between tidal volume and EELV. Patients with ALI were divided into two subgroups according to the median strain value (0.27). RESULTS:Patients in the ALI group exhibited higher airway pressures, lower EELV and higher strain than the control group. There were no significant differences in gas exchange, respiratory mechanics, or the matrix remodeling markers between ALI patients with normal and high strain. The subgroup of patients with high strain showed a fourfold increase of IL-6 and IL-8 concentrations in BALF, compared with patients with ALI and normal strain or patients without ALI. In the whole sample, IL-6 and IL-8 concentrations in BALF were correlated with strain (Spearman's ρ = 0.67 and 0.77, respectively). CONCLUSIONS: Increased strain is associated with a proinflammatory lung response in patients with ALI.
Authors: Katherine J Deans; Peter C Minneci; Xizhong Cui; Steven M Banks; Charles Natanson; Peter Q Eichacker Journal: Crit Care Med Date: 2005-05 Impact factor: 7.598
Authors: G R Bernard; A Artigas; K L Brigham; J Carlet; K Falke; L Hudson; M Lamy; J R LeGall; A Morris; R Spragg Journal: Intensive Care Med Date: 1994 Impact factor: 17.440
Authors: V M Ranieri; P M Suter; C Tortorella; R De Tullio; J M Dayer; A Brienza; F Bruno; A S Slutsky Journal: JAMA Date: 1999-07-07 Impact factor: 56.272
Authors: Tyler J Wellman; Tilo Winkler; Eduardo L V Costa; Guido Musch; R Scott Harris; Hui Zheng; Jose G Venegas; Marcos F Vidal Melo Journal: Crit Care Med Date: 2014-07 Impact factor: 7.598
Authors: Andreas Schwingshackl; Bin Teng; Patrudu Makena; Manik Ghosh; Scott E Sinclair; Charlean Luellen; Louisa Balasz; Cynthia Rovnaghi; Robert M Bryan; Eric E Lloyd; Elizabeth Fitzpatrick; Jordy S Saravia; Stephania A Cormier; Christopher M Waters Journal: Crit Care Med Date: 2014-11 Impact factor: 7.598
Authors: Andreas Schwingshackl; Bin Teng; Manik Ghosh; Keng Gat Lim; Gabor Tigyi; Damodaran Narayanan; Jonathan H Jaggar; Christopher M Waters Journal: Am J Physiol Lung Cell Mol Physiol Date: 2012-12-28 Impact factor: 5.464
Authors: Gabriel C Motta-Ribeiro; Soshi Hashimoto; Tilo Winkler; Rebecca M Baron; Kira Grogg; Luís F S C Paula; Arnoldo Santos; Congli Zeng; Kathryn Hibbert; Robert S Harris; Ednan Bajwa; Marcos F Vidal Melo Journal: Am J Respir Crit Care Med Date: 2018-10-01 Impact factor: 21.405
Authors: J Dellamonica; N Lerolle; C Sargentini; S Hubert; G Beduneau; F Di Marco; A Mercat; J L Diehl; J C M Richard; G Bernardin; L Brochard Journal: Intensive Care Med Date: 2013-01-24 Impact factor: 17.440
Authors: Maurizio Cereda; Yi Xin; Natalie Meeder; Johnathan Zeng; YunQing Jiang; Hooman Hamedani; Harrilla Profka; Stephen Kadlecek; Justin Clapp; Charuhas G Deshpande; Jue Wu; James C Gee; Brian P Kavanagh; Rahim R Rizi Journal: Anesthesiology Date: 2016-01 Impact factor: 7.892