| Abdominal lymph flow in an endotoxin sepsis model: influence of spontaneous breathing and mechanical ventilation. | |
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MedLine Citation:
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PMID: 16971857 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Lymph flow from the abdomen was investigated in a sepsis model. We also compared the effect on thoracic duct lymph flow of mechanical ventilation with different levels of positive end-expiratory pressure (PEEP) and spontaneous breathing with continuous positive airway pressure (CPAP). DESIGN: Experimental study. SETTING: Research laboratory in a university hospital. SUBJECTS: Thirty-two pigs. INTERVENTIONS: Animals were anesthetized. In study 1 (n = 18), an ultrasonic flow probe was put around the intact thoracic duct just caudal to the diaphragm, and animals were randomized to receive mechanical ventilation with a PEEP of 5 cm H2O or 15 cm H2O or breathed spontaneously in CPAP with a PEEP of 5 cm H2O. In study 2 (n = 6), the thoracic duct was cannulated and the cannula externalized through the abdominal wall for lymph collection; animals were then ventilated as in study 1. In all animals, endotoxin was infused at 15 microg/kg/hr for 2.5 hrs and then continued at 5 microg/kg/hr. In study 3, healthy (n = 4) and endotoxin-exposed (n = 4) pigs had intra-abdominal pressure increased to 27 cm H2O for 2 hrs by pneumoperitoneum. Lymph flow was measured as in study 1. MEASUREMENTS AND MAIN RESULTS: Lymph flow (mean +/- SE) was 2.5 +/- 0.4 mL/min at baseline and increased to 3.9 +/- 0.8 mL/min after 90 mins and 6.3 +/- 1.6 mL/min after 150 mins (p < .005) of endotoxin exposure. PEEP 15 cm H2O decreased lymph flow in pigs with intact thoracic duct (flow probe recording) and in pigs with cannulated lymph duct when drained against the central venous pressure. However, when drained against atmospheric pressure, PEEP increased flow. Spontaneous breathing increased flow both in intact and in cannulated animals. CONCLUSIONS: Endotoxin increases lymph flow from the abdomen. Mechanical ventilation with high PEEP impedes lymph drainage and could increase lymph production. Spontaneous breathing increases flow and improves drainage of abdominal edema. |
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Authors:
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Marco Lattuada; Göran Hedenstierna |
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Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Critical care medicine Volume: 34 ISSN: 0090-3493 ISO Abbreviation: Crit. Care Med. Publication Date: 2006 Nov |
Date Detail:
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Created Date: 2006-10-20 Completed Date: 2006-11-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 2792-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Medical Sciences, Clinical Physiology, University Hospital, Uppsala, Sweden. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abdomen Animals Continuous Positive Airway Pressure* Lipopolysaccharides Lymph / metabolism* Positive-Pressure Respiration / methods* Sepsis / physiopathology, therapy* Swine Thoracic Duct / metabolism |
| Chemical | |
Reg. No./Substance:
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0/Lipopolysaccharides |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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