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Báo cáo y học: "Open lung approach associated with highfrequency oscillatory or low tidal volume mechanical ventilation improves respiratory function and minimizes lung injury in healthy and injured rats"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Open lung approach associated with highfrequency oscillatory or low tidal volume mechanical ventilation improves respiratory function and minimizes lung injury in healthy and injured rats. | Krebs et al. Critical Care 2010 14 R183 http ccforum.eom content 14 5 R183 c CRITICAL CARE RESEARCH Open Access Open lung approach associated with high-frequency oscillatory or low tidal volume mechanical ventilation improves respiratory function and minimizes lung injury in healthy and injured rats 12 11 3 4 Joerg Krebs Paolo Pelosi Charalambos Tsagogiorgas Liesa Zoeller Patricia RM Rocco Benito Yard Thomas Luecke1 Abstract Introduction To test the hypothesis that open lung OL ventilatory strategies using high-frequency oscillatory ventilation HFOV or controlled mechanical ventilation CMV compared to CMV with lower positive end-expiratory pressure PEEP improve respiratory function while minimizing lung injury as well as systemic inflammation a prospective randomized study was performed at a university animal laboratory using three different lung conditions. Methods Seventy-eight adult male Wistar rats were randomly assigned to three groups 1 uninjured UI 2 saline washout SW and 3 intraperitoneal intravenous Escherichia coli lipopolysaccharide LPS -induced lung injury. Within each group animals were further randomized to 1 OL with HFOV 2 OL with CMV with best PEEP set according to the minimal static elastance of the respiratory system BP-CMV and 3 CMV with low PEEP LP-CMV . They were then ventilated for 6 hours. HFOV was set with mean airway pressure PmeanHFOV at 2 cm H2O above the mean airway pressure recorded at BP-CMV PmeanBP-CMV following a recruitment manoeuvre. Six animals served as unventilated controls C . Gas-exchange respiratory system mechanics lung histology plasma cytokines as well as cytokines and types I and III procollagen PCI and PCIII mRNA expression in lung tissue were measured. Results We found that 1 in both SW and LPS HFOV and BP-CMV improved gas exchange and mechanics with lower lung injury compared to LP-CMV 2 in SW HFOV yielded better oxygenation than BP-CMV 3 in SW interleukin IL -6 mRNA expression was lower during BP-CMV and HFOV compared