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Ventilator induced lung injury

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https://www.readbyqxmd.com/read/27913141/acute-lung-injury-and-persistent-small-airway-disease-in-a-rabbit-model-of-chlorine-inhalation
#1
Sadiatu Musah, Connie F Schlueter, David M Humphrey, Karen S Powell, Andrew M Roberts, Gary W Hoyle
Chlorine is a pulmonary toxicant to which humans can be exposed through accidents or intentional releases. Acute effects of chlorine inhalation in humans and animal models have been well characterized, but less is known about persistent effects of acute, high-level chlorine exposures. In particular, animal models that reproduce the long-term effects suggested to occur in humans are lacking. Here, we report the development of a rabbit model in which both acute and persistent effects of chlorine inhalation can be assessed...
November 29, 2016: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/27911872/p120-regulates-beta-catenin-nuclear-translocation-through-e-cadherin-endocytosis-in-ventilator-induced-lung-injury
#2
Changping Gu, Chenyang Dai, Yongtao Sun, Mengjie Liu, Yuelan Wang, Xinyi Wu
Mechanical stretch induces epithelial barrier dysfunction by altering the location and degradation of cellular junction proteins. p120-catenin (p120) is a cell-cell junction protein known to protect against ventilator-induced lung injury (VILI) that results from improper ventilation of patients. In this study, we sought to determine the role of p120 in VILI and its relationship with the cellular response to mechanical stretch. Mouse lung epithelial cells (MLE-12) transfected with p120 siRNA, p120 cDNA, or E-cadherin siRNA were subjected to 20% cyclic stretch for 2 or 4 hours...
November 30, 2016: Oncotarget
https://www.readbyqxmd.com/read/27899539/reliability-of-displayed-tidal-volume-in-healthy-and-surfactant-depleted-piglets
#3
A Cecilia Mendiondo Luedloff, Tracy L Thurman, Shirley J Holt, Shasha Bai, Mark J Heulitt, Sherry E Courtney
BACKGROUND: Volutrauma has been established as the key factor in ventilator-induced lung injury and can only be avoided if tidal volume (VT) is accurately displayed and delivered. The purpose of this study was to investigate the accuracy of displayed exhaled VT in a ventilator commonly used in small infants with or without a proximal flow sensor and using 3 methods to achieve a target VT in both a healthy and lung-injured neonatal pig model. METHODS: This was a prospective animal study utilizing 8 male pigs, approximately 2...
December 2016: Respiratory Care
https://www.readbyqxmd.com/read/27875410/should-we-use-driving-pressure-to-set-tidal-volume
#4
Domenico L Grieco, Lu Chen, Martin Dres, Laurent Brochard
PURPOSE OF REVIEW: Ventilator-induced lung injury (VILI) can occur despite use of tidal volume (VT) limited to 6 ml/kg of predicted body weight, especially in patients with a smaller aerated compartment (i.e. the baby lung) in which, indeed, tidal ventilation takes place. Because respiratory system static compliance (CRS) is mostly affected by the volume of the baby lung, the ratio VT/CRS (i.e. the driving pressure, ΔP) may potentially help tailoring interventions on VT setting. RECENT FINDINGS: Driving pressure is the ventilatory variable most strongly associated with changes in survival and has been shown to be the key mediator of the effects of mechanical ventilation on outcome in the acute respiratory distress syndrome...
November 19, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27873331/low-tidal-volume-reduces-lung-inflammation-induced-by-liquid-ventilation-in-piglets-with-severe-lung-injury
#5
Lijun Jiang, Huizhen Feng, Xiaofan Chen, Kaifeng Liang, Chengyao Ni
Total liquid ventilation (TLV) is an alternative treatment for severe lung injury. High tidal volume is usually required for TLV to maintain adequate CO2 clearance. However, high tidal volume may cause alveolar barotrauma. We aim to investigate the effect of low tidal volume on pulmonary inflammation in piglets with lung injury and under TLV. After the establishment of acute lung injury model by infusing lipopolysaccharide, 12 piglets were randomly divided into two groups, TLV with high tidal volume (25 mL/kg) or with low tidal volume (6 mL/kg) for 240 min, respectively...
November 21, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27865481/the-influence-of-tethering-and-gravity-on-the-stability-of-compliant-liquid-lined-airways
#6
Jeremy Whang, Chandler Faulman, Thomas A Itin, Donald P Gaver
This study revolves around two simple questions: 1) how does pulmonary airway recruitment/de-recruitment (RecDer) depend on the tethering support provided by surrounding airways and alveoli, and 2) does airway angle of inclination (θ) influence airway stability? These two questions are critical to understanding the existence and prevention of atelectrauma, which may contribute to ventilator-induced lung injury (VILI). To address these questions, we develop PDMS 2mm ID compliant tubes that mimic pulmonary airways...
November 11, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27861175/transient-receptor-potential-vanilloid-4-and-serum-glucocorticoid-regulated-kinase-1-are-critical-mediators-of-lung-injury-in-overventilated-mice-in-vivo
#7
Laura Michalick, Lasti Erfinanda, Ulrike Weichelt, Markus van der Giet, Wolfgang Liedtke, Wolfgang M Kuebler
BACKGROUND: Mechanical ventilation can cause lung endothelial barrier failure and inflammation cumulating in ventilator-induced lung injury. Yet, underlying mechanotransduction mechanisms remain unclear. Here, the authors tested the hypothesis that activation of the mechanosensitive Ca channel transient receptor potential vanilloid (TRPV4) by serum glucocorticoid-regulated kinase (SGK) 1 may drive the development of ventilator-induced lung injury. METHODS: Mice (total n = 54) were ventilated for 2 h with low (7 ml/kg) or high (20 ml/kg) tidal volumes and assessed for signs of ventilator-induced lung injury...
November 18, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27855271/experimental-lung-injury-reduces-klf2-to-increase-endothelial-permeability-via-regulation-of-rapgef3-rac1-signaling
#8
Ru-Ting Huang, David Wu, Angelo Meliton, Myung-Jin Oh, Matthew Krause, Joyce A Lloyd, Recep Nigdelioglu, Robert B Hamanaka, Mukesh K Jain, Anna Birukova, John P Kress, Konstantin G Birukov, Gökhan M Mutlu, Yun Fang
RATIONALE: The acute respiratory distress syndrome (ARDS) is caused by widespread endothelial barrier disruption and uncontrolled cytokine storm. Genome-wide association studies (GWAS) have linked multiple genes to ARDS. Although mechano-sensitive transcription factor Krüppel-like factor 2 (KLF2) is a major regulator of endothelial function, its role in regulating pulmonary vascular integrity in lung injury and ARDS-associated GWAS genes remains poorly understood. OBJECTIVES: To examine KLF2 expression in multiple animal models of acute lung injury and further elucidate the KLF2-mediated pathways involved in endothelial barrier disruption and cytokine storm in experimental lung injury...
November 17, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27842744/ventilator-induced-lung-injury
#9
REVIEW
Jeremy R Beitler, Atul Malhotra, B Taylor Thompson
Prevention of ventilator-induced lung injury (VILI) can attenuate multiorgan failure and improve survival in at-risk patients. Clinically significant VILI occurs from volutrauma, barotrauma, atelectrauma, biotrauma, and shear strain. Differences in regional mechanics are important in VILI pathogenesis. Several interventions are available to protect against VILI. However, most patients at risk of lung injury do not develop VILI. VILI occurs most readily in patients with concomitant physiologic insults. VILI prevention strategies must balance risk of lung injury with untoward side effects from the preventive effort, and may be most effective when targeted to subsets of patients at increased risk...
December 2016: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/27836935/extracorporeal-membrane-oxygenation-ecmo-for-lung-injury-in-severe-acute-respiratory-distress-syndrome-ards-review-of-the-literature
#10
Summer Paolone
Despite advances in mechanical ventilation, severe acute respiratory distress syndrome (ARDS) is associated with high morbidity and mortality rates ranging from 26% to 58%. Extracorporeal membrane oxygenation (ECMO) is a modified cardiopulmonary bypass circuit that serves as an artificial membrane lung and blood pump to provide gas exchange and systemic perfusion for patients when their own heart and lungs are unable to function adequately. ECMO is a complex network that provides oxygenation and ventilation and allows the lungs to rest and recover from respiratory failure while minimizing iatrogenic ventilator-induced lung injury...
November 10, 2016: Clinical Nursing Research
https://www.readbyqxmd.com/read/27826324/respiratory-support-with-heated-humidified-high-flow-nasal-cannula-in-preterm-infants
#11
REVIEW
Ga Won Jeon
The incidence of bronchopulmonary dysplasia (BPD) has not decreased over the last decade. The most important way to decrease BPD is by weaning the patient from the ventilator as soon as possible in order to reduce ventilator-induced lung injury that underlies BPD, and by using a noninvasive ventilator (NIV). Use of a heated, humidified, high flow nasal cannula (HHHFNC), which is the most recently introduced NIV mode for respiratory support in preterm infants, is rapidly increasing in many neonatal intensive care units due to the technical ease of use without sealing, and the attending physician's preference compared to other NIV modes...
October 2016: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/27815258/inflammation-and-lung-injury-in-an-ovine-model-of-extracorporeal-membrane-oxygenation-support
#12
Margaret Passmore, Yoke L Fung, Gabriela Simonova, Samuel R Foley, Kimble R Dunster, Sara D Diab, John-Paul Tung, Robyn M Minchinton, Charles I McDonald, Chris M Anstey, Kiran Shekar, John F Fraser
Extracorporeal membrane oxygenation (ECMO) is a life-saving treatment for patients with severe, refractory, cardiorespiratory failure. Exposure to the ECMO circuit is thought to trigger/exacerbate inflammation. Determining whether inflammation is due to the patients underlying pathologies or the ECMO circuit is difficult. To discern how different insults contribute to the inflammatory response we developed an ovine model of lung injury and ECMO to investigate the impact of smoke-induced lung injury and ECMO in isolation and cumulatively on pulmonary and circulating inflammatory cells, cytokines and tissue remodeling...
November 4, 2016: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/27812430/synthetic-lung-surfactants-containing-sp-b-and-sp-c-peptides-plus-novel-phospholipase-resistant-lipids-or-glycerophospholipids
#13
Robert H Notter, Rohun Gupta, Adrian L Schwan, Zhengdong Wang, Mohanad Gh Shkoor, Frans J Walther
BACKGROUND: This study examines the biophysical and preclinical pulmonary activity of synthetic lung surfactants containing novel phospholipase-resistant phosphonolipids or synthetic glycerophospholipids combined with Super Mini-B (S-MB) DATK and/or SP-Css ion-lock 1 peptides that replicate the functional biophysics of surfactant proteins (SP)-B and SP-C. Phospholipase-resistant phosphonolipids used in synthetic surfactants are DEPN-8 and PG-1, molecular analogs of dipalmitoyl phosphatidylcholine (DPPC) and palmitoyl-oleoyl phosphatidylglycerol (POPG), while glycerophospholipids used are active lipid components of native surfactant (DPPC:POPC:POPG 5:3:2 by weight)...
2016: PeerJ
https://www.readbyqxmd.com/read/27811142/loss-of-epithelial-gq-and-g11-signaling-inhibits-tgf%C3%AE-production-but-promotes-il-33-mediated-macrophage-polarization-and-emphysema
#14
Alison E John, Michael R Wilson, Anthony Habgood, Joanne Porte, Amanda L Tatler, Anastasios Stavrou, Gino Miele, Lisa Jolly, Alan J Knox, Masao Takata, Stefan Offermanns, R Gisli Jenkins
Heterotrimeric guanine nucleotide-binding protein (G protein) signaling links hundreds of G protein-coupled receptors with four G protein signaling pathways. Two of these, one mediated by Gq and G11 (Gq/11) and the other by G12 and G13 (G12/13), are implicated in the force-dependent activation of transforming growth factor-β (TGFβ) in lung epithelial cells. Reduced TGFβ activation in alveolar cells leads to emphysema, whereas enhanced TGFβ activation promotes acute lung injury and idiopathic pulmonary fibrosis...
October 25, 2016: Science Signaling
https://www.readbyqxmd.com/read/27794083/the-effect-of-compartmental-asymmetry-on-the-monitoring-of-pulmonary-mechanics-and-lung-volumes
#15
Joseph C Keenan, Gustavo A Cortes-Puentes, Alexander B Adams, David J Dries, John J Marini
BACKGROUND: Esophageal pressure measurement for computation of transpulmonary pressure (Ptp) has begun to be incorporated into clinical use for evaluating forces across the lungs. Gaps exist in our understanding of how esophageal pressure (and therefore Ptp), a value measured at a single site, responds when respiratory system compartments are asymmetrically affected by whole-lung atelectasis or unilateral injury as well as changes in chest wall compliance. We reasoned that Ptp would track with aerated volume changes as estimated by functional residual capacity (FRC) and tidal volume...
November 2016: Respiratory Care
https://www.readbyqxmd.com/read/27787436/mitochondrial-dna-damps-in-ventilator-associated-pneumonia-prevention-and-reversal-by-intratracheal-dnase-i
#16
Jon D Simmons, Daniel R Freno, C Annie Muscat, Boniface Obiako, Yann-Leei L Lee, Viktor M Pastukh, Sidney B Brevard, Mark N Gillespie
INTRODUCTIONS: Previous studies in isolated perfused rat lungs have revealed that endothelial barrier disruption after intra-tracheal administration of pseudomonas aeruginosa (strain 103; PA103) only occurs after accumulation of extracellular mitochondrial DNA (mtDNA) Damage Associated Molecular Patterns (DAMPs) in the perfusate and is suppressed by addition of DNase to the perfusion medium. Herein, we tested the hypothesis that intra-tracheal DNase - a route of administration readily translatable to patient with ventilator-associated pneumonia (VAP) - also enhances degradation of mtDNA and prevents bacteria-induced lung injury...
October 25, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27783650/vegf-production-by-ly6c-high-monocytes-contributes-to-ventilator-induced-lung-injury
#17
Chung-Sheng Shi, Tzu-Hsiung Huang, Chin-Kuo Lin, Jhy-Ming Li, Mei-Hsin Chen, Mei-Ling Tsai, Chih-Ching Chang
BACKGROUND: Mechanical ventilation is a life-saving procedure for patients with acute respiratory failure, although it may cause pulmonary vascular inflammation and leakage, leading to ventilator-induced lung injury (VILI). Ly6C+high monocytes are involved in the pathogenesis of VILI. In this study, we investigated whether pulmonary infiltrated Ly6C+high monocytes produce vascular endothelial growth factor (VEGF) and contribute to VILI. METHODS: A clinically relevant two-hit mouse model of VILI, with intravenous lipopolysaccharide (LPS, 20 ng/mouse) immediately before high tidal volume (HTV, 20 mL/kg) ventilation (LPS+HTV), was established...
2016: PloS One
https://www.readbyqxmd.com/read/27782948/sevoflurane-abolishes-oxygenation-impairment-in-a-long-term-rat-model-of-acute-lung-injury
#18
Patrick Kellner, Mattia Müller, Tobias Piegeler, Philipp Eugster, Christa Booy, Martin Schläpfer, Beatrice Beck-Schimmer
BACKGROUND: Patients experiencing acute lung injury (ALI) often need mechanical ventilation for which sedation may be required. In such patients, usually the first choice an intravenously administered drug. However, growing evidence suggests that volatile anesthetics such as sevoflurane are a valuable alternative. In this study, we evaluate pulmonary and systemic effects of long-term (24-hour) sedation with sevoflurane compared with propofol in an in vivo animal model of ALI. METHODS: Adult male Wistar rats were subjected to ALI by intratracheal lipopolysaccharide (LPS) application, mechanically ventilated and sedated for varying intervals up to 24 hours with either sevoflurane or propofol...
October 24, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27766893/optimal-mechanical-ventilation-strategies-to-minimize-ventilator-induced-lung-injury-in-non-injured-and-injured-lungs
#19
Pedro L Silva, Paolo Pelosi, Patricia R M Rocco
No abstract text is available yet for this article.
November 4, 2016: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/27763913/the-open-lung-approach-improves-pulmonary-vascular-mechanics-in-an-experimental-model-of-acute-respiratory-distress-syndrome
#20
Arnoldo Santos, Luca Lucchetta, M Ignacio Monge-Garcia, Joao Batista Borges, Gerardo Tusman, Goran Hedenstierna, Anders Larsson, Fernando Suarez-Sipmann
OBJECTIVE: To test whether positive end-expiratory pressure consistent with an open lung approach improves pulmonary vascular mechanics compared with higher or lower positive end-expiratory pressures in experimental acute respiratory distress syndrome. DESIGN: Experimental study. SETTING: Animal research laboratory. SUBJECTS: Ten pigs, 35 ± 5.2 kg. INTERVENTIONS: Acute respiratory distress syndrome was induced combining saline lung lavages with injurious mechanical ventilation...
October 19, 2016: Critical Care Medicine
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