| Conflicting Physiological and Genomic Cardiopulmonary Effects of Recruitment Maneuvers in Murine Acute Lung Injury. | |
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MedLine Citation:
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PMID: 22135358 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Rationale: Low tidal volume ventilation, although promoting atelectasis, is a protective strategy against ventilator-induced lung injury. Deep inflation recruitment maneuvers restore lung volumes but potentially compromise lung parenchymal and vascular function via repetitive over-distention. Our objective was to examine cardiopulmonary physiological and transcriptional consequences of recruitment maneuvers. Methods: C57/BL6 mice challenged with either phosphate-buffered saline (PBS) or lipopolysaccharide (LPS) via aspiration were placed on mechanical ventilation (5 hours) using low tidal volume inflation (8 µL/g) alone (TI) or in combination with intermittent deep inflations (0.75 mL twice per minute, DI). Results: Lung mechanics during TI ventilation significantly deteriorated as assessed by forced oscillation technique and pressure-volume curves. DI mitigated the TI-induced alterations in lung mechanics but induced a significant rise in right ventricle systolic pressures and pulmonary vascular resistances, especially in LPS/TI-challenged animals. In addition, DI exacerbated the LPS-induced genome-wide lung inflammatory transcriptome, with prominent dysregulation of a gene cluster involving vascular processes, as well as increases in cytokine concentrations in bronchoalveolar lavage fluid and plasma. Gene ontology analyses of right ventricular tissues expression profiles also identified inflammatory signatures as well as apoptosis and membrane organization ontologies as potential elements in the response to acute pressure overload. Conclusions: Our results, while confirming the improvement in lung mechanics offered by DI, highlight a detrimental impact in sustaining inflammatory response and exacerbating lung vascular dysfunction, events contributing to increases in right ventricle afterload. These novel insights should be integrated into the clinical assessment of the risk/benefit of recruitment maneuvers strategies. |
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Authors:
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Armand Mekontso Dessap; Guillaume Voiriot; Tong Zhou; Elisabeth Marcos; Steven M Dudek; Jeff R Jacobson; Roberto Machado; Serge Adnot; Laurent Brochard; Bernard Maitre; Joe Gn Garcia |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-12-1 |
Journal Detail:
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Title: American journal of respiratory cell and molecular biology Volume: - ISSN: 1535-4989 ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-2 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8917225 Medline TA: Am J Respir Cell Mol Biol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Unité U955 , INSERM, (Institut Mondor de Recherche Biomédicale), Créteil, France; Faculté de Médecine , Université Paris Est Créteil Val de Marne, Créteil, France; Service de Réanimation Médicale, AP-HP, Groupe Henri Mondor-Albert Chenevier, Creteil, France. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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