| Brief, large tidal volume ventilation initiates lung injury and a systemic response in fetal sheep. | |
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MedLine Citation:
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PMID: 17641159 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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RATIONALE: Premature infants are exposed to potentially injurious ventilation in the delivery room. Assessments of lung injury are confounded by effects of subsequent ventilatory support. OBJECTIVES: To evaluate the injury response to a brief period of large tidal volume (Vt) ventilation, simulating neonatal resuscitation in preterm neonates. METHODS: Preterm lambs (129 d gestation; term is150 d) were ventilated (Vt = 15 ml/kg, no positive end-expiratory pressure) for 15 minutes to simulate delivery room resuscitation, either with the placental circulation intact (fetal resuscitation [ FR]) or after delivery (neonatal resuscitation [NR]). After the initial 15 minutes, lambs received surfactant and were maintained with either ventilatory support (FR-VS and NR-VS) or placental support (FR-PS) for 2 hours, 45 minutes. A control group received no resuscitation and was maintained with placental support. Samples of bronchoalveolar lavage fluid, lung, and liver were analyzed. MEASUREMENTS AND MAIN RESULTS: Inflammatory cells and protein in bronchoalveolar lavage fluid, heat shock protein-70 immunostaining, IL-1beta, IL-6, IL-8, monocyte chemotactic protein-1, serum amyloid A (SAA)-3, Toll-like receptor (TLR)-2, and TLR4 mRNA in the lungs were increased in the FR-PS group compared with control animals. There were further elevations in neutrophils, IL-6, and IL-8 mRNA in the FR-VS and NR-VS groups compared with FR-PS. SAA3, TLR2, and TLR4 mRNA increased in the liver in all resuscitation groups relative to control animals. CONCLUSIONS: Ventilation for 15 minutes with a Vt of 15 ml/kg initiates an injurious process in the preterm lung and a hepatic acute-phase response. Subsequent ventilatory support causes further increases in some injury indicators. |
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Authors:
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Noah H Hillman; Timothy J M Moss; Suhas G Kallapur; Cindy Bachurski; J Jane Pillow; Graeme R Polglase; Ilias Nitsos; Boris W Kramer; Alan H Jobe |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2007-07-19 |
Journal Detail:
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Title: American journal of respiratory and critical care medicine Volume: 176 ISSN: 1073-449X ISO Abbreviation: Am. J. Respir. Crit. Care Med. Publication Date: 2007 Sep |
Date Detail:
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Created Date: 2007-09-07 Completed Date: 2007-10-18 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 9421642 Medline TA: Am J Respir Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 575-81 Citation Subset: AIM; IM |
Affiliation:
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Cincinnati Children's Hospital Medical Center, Division of Pulmonary Biology, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Biological Markers / metabolism Bronchoalveolar Lavage Fluid / chemistry* Chemokine CCL2 / metabolism Disease Models, Animal Female HSP70 Heat-Shock Proteins / metabolism Immunohistochemistry Interleukins / metabolism Liver / metabolism Lung / metabolism* Lung Diseases / embryology, etiology*, metabolism Pregnancy RNA, Messenger / analysis Respiration, Artificial / adverse effects* Resuscitation / methods Serum Amyloid A Protein / metabolism Severity of Illness Index Sheep Tidal Volume* Toll-Like Receptor 2 / metabolism Toll-Like Receptor 4 / genetics, metabolism |
| Grant Support | |
ID/Acronym/Agency:
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HD-12714/HD/NICHD NIH HHS; HD07541/HD/NICHD NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Chemokine CCL2; 0/HSP70 Heat-Shock Proteins; 0/Interleukins; 0/RNA, Messenger; 0/Serum Amyloid A Protein; 0/Toll-Like Receptor 2; 0/Toll-Like Receptor 4 |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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