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Ventilator induced lung injury

Pedro L Silva, Paolo Pelosi, Patricia R M Rocco
No abstract text is available yet for this article.
October 21, 2016: Expert Review of Respiratory Medicine
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
Gisele de A Padilha, Lucas F B Horta, Lillian Moraes, Cassia L Braga, Milena V Oliveira, Cíntia L Santos, Isalira P Ramos, Marcelo M Morales, Vera Luiza Capelozzi, Regina C S Goldenberg, Marcelo Gama de Abreu, Paolo Pelosi, Pedro L Silva, Patricia R M Rocco
BACKGROUND: In patients with emphysema, invasive mechanical ventilation settings should be adjusted to minimize hyperinflation while reducing respiratory effort and providing adequate gas exchange. We evaluated the impact of pressure-controlled ventilation (PCV) and pressure support ventilation (PSV) on pulmonary and diaphragmatic damage, as well as cardiac function, in experimental emphysema. METHODS: Emphysema was induced by intratracheal instillation of porcine pancreatic elastase in Wistar rats, once weekly for 4 weeks...
December 2016: Intensive Care Medicine Experimental
Cynthia S Samary, Pedro L Silva, Marcelo Gama de Abreu, Paolo Pelosi, Patricia R M Rocco
No abstract text is available yet for this article.
November 2016: Anesthesiology
Jonne Doorduin, Joeke L Nollet, Lisanne H Roesthuis, Hieronymus W H van Hees, Laurent J Brochard, Christer A Sinderby, Johannes G van der Hoeven, Leo M A Heunks
RATIONALE: Controlled mechanical ventilation is used to deliver lung-protective ventilation in patients with acute respiratory distress syndrome. Despite recognized benefits, such as preserved diaphragm activity, partial support ventilation modes may be incompatible with lung-protective ventilation due to high tidal volume and high transpulmonary pressure. As an alternative to high dose sedatives and controlled mechanical ventilation, pharmacologically induced neuromechanical uncoupling of the diaphragm should facilitate lung-protective ventilation under partial support modes...
October 17, 2016: American Journal of Respiratory and Critical Care Medicine
Julia Scheiermann, Dennis M Klinman
BACKGROUND: Mechanical ventilation (MV) is commonly used to improve blood oxygenation in critically ill patients and for general anesthesia. Yet the cyclic mechanical stress induced at even moderate ventilation volume settings [tidal volume (Vt) <10 mL/kg] can injure the lungs and induce an inflammatory response. This work explores the effect of treatment with suppressive oligonucleotides (Sup ODN) in a mouse model of ventilator-induced lung injury (VILI). METHODS: Balb/cJ mice were mechanically ventilated for 4 h using clinically relevant Vt and a positive end-expiratory pressure of 3 cmH2O under 2-3% isoflurane anesthesia...
September 2016: Journal of Thoracic Disease
Y Wu, L Wang, L Meng, G-K Cao, Y Zhang
OBJECTIVE: In this study the levels of macrophage inflammatory protein-1α and NF-κB were measured in patients suffering acute kidney injury secondary to acute lung injury induced by mechanical ventilation and in controls, to determine whether they are differentially expressed. PATIENTS AND METHODS: 160 patients were enrolled in our study: 40 had acute kidney injury secondary to acute lung injury induced by mechanical ventilation (group A), 40 had acute lung injury induced by mechanical ventilation, but no secondary acute kidney injury (group B), 40 were treated with mechanical ventilation but suffered no complications (group C), and 40 were treated with a conventional nasal catheter or oxygen mask inhalation (group D)...
September 2016: European Review for Medical and Pharmacological Sciences
Nicholas Drachman, Stephen Kadlecek, Mehrdad Pourfathi, Yi Xin, Harilla Profka, Rahim Rizi
PURPOSE: To optimize the production of hyperpolarized (13) C-bicarbonate from the decarboxylation of hyperpolarized [1-(13) C]pyruvate and use it to image pH in the lungs and heart of rats with acute lung injury. METHODS: Two forms of catalysis are compared calorimetrically to maximize the rate of decarboxylation and rapidly produce hyperpolarized bicarbonate from pyruvate while minimizing signal loss. Rats are injured using an acute lung injury model combining ventilator-induced lung injury and acid aspiration...
October 7, 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Clair Hartmann, Sebastian Hafner, Angelika Scheuerle, Peter Möller, Markus Huber-Lang, Birgit Jung, Benedikt Nubaum, Oscar McCook, Michael Gröger, Florian Wagner, Sandra Weber, Bettina Stahl, Enrico Calzia, Michael Georgieff, Csaba Szabó, Rui Wang, Peter Radermacher, Katja Wagner
Pre-traumatic cigarette smoke (CS) exposure aggravates post-traumatic acute lung injury (ALI). Cystathionine-γ-lyase (CSE) protects against ALI and CS exposure-induced chronic obstructive lung disease (COPD). Therefore, we tested the hypothesis whether genetic CSE knockout (CSE) would aggravate post-traumatic ALI after CS exposure. After 3-4 weeks of CS exposure, anesthetized wild type (WT) and CSE mice underwent blunt chest trauma, surgical instrumentation and 4 hours of lung-protective mechanical ventilation...
September 28, 2016: Shock
Martin Russ, Sebastian Kronfeldt, Willehad Boemke, Thilo Busch, Roland C E Francis, Philipp A Pickerodt
Various animal models of lung injury exist to study the complex pathomechanisms of human acute respiratory distress syndrome (ARDS) and evaluate future therapies. Severe lung injury with a reproducible deterioration of pulmonary gas exchange and hemodynamics can be induced in anesthetized pigs using repeated lung lavages with warmed 0.9% saline (50 ml/kg body weight). Including standard respiratory and hemodynamic monitoring with clinically applied devices in this model allows the evaluation of novel therapeutic strategies (drugs, modern ventilators, extracorporeal membrane oxygenators, ECMO), and bridges the gap between bench and bedside...
2016: Journal of Visualized Experiments: JoVE
Ken-Ichiro Tanaka, Fumiya Tamura, Toshifumi Sugizaki, Masahiro Kawahara, Keiji Kuba, Yumiko Imai, Tohru Mizushima
RATIONALE: For acute respiratory distress syndrome (ARDS), mechanical ventilation (MV) is a life-saving intervention without alternative, however, MV can cause ventilator-induced lung injury (VILI). Reactive oxygen species (ROS) play important roles in the pathogenesis of both ARDS and VILI. Lecithinized superoxide dismutase (PC-SOD) has overcome limitations of SOD such as low tissue affinity and low stability in plasma. OBJECTIVES: In this study, we have examined the effect of PC-SOD on tissue injury, edema and inflammation in the lung and other organs of mice subjected to cecal ligation and puncture (CLP), lipopolysaccharide (LPS) administration or MV...
September 26, 2016: American Journal of Respiratory Cell and Molecular Biology
Wei Gao, Ying-Nan Ju
BACKGROUND AND AIMS: Patients with acute respiratory distress syndrome (ARDS) are particularly susceptible to ventilator-induced lung injury (VILI). This study investigated the effect of budesonide on VILI in a rat model of inflammatory ARDS. METHODS: Forty eight rats were randomized into three groups (n = 16 each): sham group (S), endotoxin/ventilation group (LV), endotoxin/ventilation/budesonide group (LVB). Rats in the S group received anesthesia only. Rats in the LV and LVB groups received endotoxin to simulate ARDS and were mechanically ventilated for 4 h (tidal volume 30 mL/kg)...
May 2016: Archives of Medical Research
Jeffrey J Fletcher, Thomas J Wilson, Venkatakrishna Rajajee, Scott B Davidson, Jon C Walsh
PURPOSE: Airway pressure release ventilation (APRV) utilizes high levels of airway pressure coupled with brief expiratory release to facilitate open lung ventilation. The aim of our study was to evaluate the effects of APRV-induced elevated airway pressure mean in patients with severe traumatic brain injury. MATERIALS AND METHODS: This was a retrospective cohort study at a 424-bed Level I trauma center. Linear mixed effects models were developed to assess the difference in therapeutic intensity level (TIL), intracranial pressure (ICP), and cerebral perfusion pressure (CPP) over time following the application of APRV...
September 20, 2016: Journal of Intensive Care Medicine
Xiaofang Huang, Wei Zhou, Shifang Ding
OBJECTIVE: To explore the effect of Smad4 on the extracellular matrix remodeling in ventilator-induced lung injury (VILI). METHODS: We randomized 24 C57BL/6 mice to 4 groups for treatment (n=6/group): control, ventilation, non-targeted (scramble) lentivirus transfection plus ventilation, and Smad4 small interfering RNA (siRNA) lentivirus transfection plus ventilation. Lentivirus was delivered by intranasal instillation. Four weeks later, the 3 ventilated groups underwent high tidal volume (VT 40mL/kg) ventilation to induce lung injury...
September 2016: Annals of Clinical and Laboratory Science
Christopher Lotz, Norbert Roewer, Ralf M Muellenbach
Mechanical ventilation is the most commonly used form of respiratory support to restore or maintain adequate gas exchange. However, mechanical ventilation does not provide a physiological form of breathing. Neither does it provide an optimal ventilation / perfusion ratio due to passive movement of the diagphragm favoring the non-dependent parts of the lung. Furthermore, patients are in danger of ventilator-associated/induced lung injury (VALI/VILI). Hence, lung protective ventilation is mandatory in patients with an acute respiratory distress syndrome (ARDS) and should likewise be used in the operating room...
September 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Laurent Brochard, Arthur Slutsky, Antonio Pesenti
Mechanical Ventilation (MV) is used to sustain life in patients with acute respiratory failure. A major concern in mechanically ventilated patients is the risk of Ventilator-Induced Lung Injury (VILI), which is partially prevented by lung protective ventilation. Spontaneously breathing, non-intubated, patients with acute respiratory failure may have a high respiratory drive and breathe with large tidal volumes and potentially injurious transpulmonary pressure swings. In patients with existing lung injury, regional forces generated by the respiratory muscles may lead to injurious effects on a regional level...
September 14, 2016: American Journal of Respiratory and Critical Care Medicine
B Cambiaghi, O Moerer, N Kunze-Szikszay, T Mauri, A Just, J Dittmar, G Hahn
A pneumothorax (PTX) is a potentially lethal condition in high-risk intensive care patients. Electrical impedance tomography (EIT) has been proven to detect PTX at the bedside. A so far not described pattern in the course of thoracic impedance at an early state of PTX was observed in a pig model of ventilator-induced lung injury (VILI) used for a more extensive study. EIT was performed at a framerate of 50 Hz. Beginning of PTX at normal ventilation, manifestation of PTX at VILI ventilation (plateau pressure 42 cm H2 O) and final pleural drainage were documented...
September 12, 2016: Clinical Physiology and Functional Imaging
Qingming Bian, Lianbing Gu, Zeping Xu, Pengyi Li, Yanning Qian, Dongya Zhu
Objective To investigate the effect of dexmedetomidine on lung injury and the expressions of Toll-like receptor 4 (TLR4), nuclear factor κB p65 (NF-κB p65) and intercellular adhesion molecular 1 (ICAM-1) mRNA during one-lung ventilation (OLV) in rabbits. Methods Thirty healthy New Zealand white rabbits were randomly divided into three groups ( n=10 in each group): two-lung ventilation (TLV) group (group T), OLV group (group O), dexmedetomidine used during OLV group (group D-O). The rabbits in group T were treated with TLV for 3...
September 2016: Xi Bao Yu Fen Zi Mian Yi Xue za Zhi, Chinese Journal of Cellular and Molecular Immunology
Shih-Hsing Yang, Jau-Chen Lin, Shih-Chi Peng, Fang Jung, Guoo-Shyng Wang Hsu, Guey-Mei Jow
Despite mechanical ventilation being a very important life-saving intervention, ventilator-induced lung injury (VILI) is related with inflammatory effects and causes high mortality. Our previous study demonstrated that the interleukin-33 (IL-33) cytokine pathway is a biomarker of VILI. The purpose of this study was to further explore the effects of hydrocortisone sodium succinate (HC) on pro-inflammatory IL-33 activation by VILI. The rats were intubated and received ventilation at 20 cmH₂O of inspiratory pressure (PC20) by a G5 ventilator for 4 h as a control group, and an intervention group received the same inspiratory pressure as well as treated with HC at 1 mg/kg at the third hour of ventilation (PC20+HC)...
October 31, 2016: Chinese Journal of Physiology
Smruti B Vaishnav, Bhalendu Vaishnav, Kailas N Desai, Nitin S Raithatha, Neeta S Bose
BACKGROUND: There is a dearth of studies on the clinical profile and therapeutic aspects of critically ill obstetric patients from rural areas, especially those requiring tertiary care support and ventilator therapy. METHODS: We retrospectively analysed the aetiological, clinical, interventional and outcome-related factors of obstetric patients requiring mechanical ventilation in western India. We analysed factors that influence seeking of antenatal care, pregnancy and its complications, severity assessment score, indications and initiation of mechanical ventilation, multiorgan failure and their correlation with maternal mortality...
March 2016: National Medical Journal of India
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