Document Detail

Brief, large tidal volume ventilation initiates lung injury and a systemic response in fetal sheep.
MedLine Citation:
PMID:  17641159     Owner:  NLM     Status:  MEDLINE    
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.
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:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2007-07-19
Journal Detail:
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:
Created Date:  2007-09-07     Completed Date:  2007-10-18     Revised Date:  2013-06-06    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  575-81     Citation Subset:  AIM; IM    
Cincinnati Children's Hospital Medical Center, Division of Pulmonary Biology, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA.
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MeSH Terms
Biological Markers / metabolism
Bronchoalveolar Lavage Fluid / chemistry*
Chemokine CCL2 / metabolism
Disease Models, Animal
HSP70 Heat-Shock Proteins / metabolism
Interleukins / metabolism
Liver / metabolism
Lung / metabolism*
Lung Diseases / embryology,  etiology*,  metabolism
RNA, Messenger / analysis
Respiration, Artificial / adverse effects*
Resuscitation / methods
Serum Amyloid A Protein / metabolism
Severity of Illness Index
Tidal Volume*
Toll-Like Receptor 2 / metabolism
Toll-Like Receptor 4 / genetics,  metabolism
Grant Support
Reg. No./Substance:
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

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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