Document Detail


Effects of different mechanical ventilation strategies on the mucociliary system.
MedLine Citation:
PMID:  20981409     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the effects of different mechanical ventilation (MV) strategies on the mucociliary system.
DESIGN AND SETTING: Experimental study.
SUBJECTS: Twenty-seven male New Zealand rabbits.
INTERVENTIONS: After anesthesia, animals were tracheotomized and ventilated with standard ventilation [tidal volume (Vt) 8 ml/kg, positive end expiratory pressure (PEEP) 5 cmH(2)O, flow 3 L/min, FiO(2) 0.4] for 30 min. Next, animals were randomized into three groups and ventilated for 3 h with low volume (LV): Vt 8 ml/kg, PEEP 5 cmH(2)O, flow 3 L/min (n = 6); high volume (HV): Vt 16 ml/kg, PEEP 5 cmH(2)O, flow 5 L/min (n = 7); or high pressure (HP): Ppeak 30 cmH(2)O, PEEP 12 cmH(2)O (n = 8). Six animals (controls) were ventilated for 10 min with standard ventilation. Vital signals, blood lactate, and respiratory system mechanics were verified. Tracheal tissue was collected before and after MV.
MEASUREMENTS: Lung and tracheal tissue sections were stained to analyze inflammation and mucosubstances by the point-counting method. Electron microscopy verified tracheal cell ultrastructure. In situ tracheal ciliary beating frequency (CBF), determined using a videoscopic technique, and tracheal mucociliary transport (TMCT), assessed by stereoscopic microscope, were evaluated before and after MV.
RESULTS: Respiratory compliance decreased in the HP group. The HV and HP groups showed higher lactate levels after MV. Macroscopy showed areas of atelectasis and congestion on HV and HP lungs. Lung inflammatory infiltrate increased in all ventilated groups. Compared to the control, ventilated animals also showed a reduction of total and acid mucus on tracheal epithelium. Under electron microscopy, injury was observed in the ciliated cells of the HP group. CBF decreased significantly after MV only in the HP group. TMCT did not change significantly in the ventilated groups.
CONCLUSIONS: Different MV strategies induce not only distal lung alterations but also morphological and physiological tracheal alterations leading to mucociliary system dysfunction.
Authors:
Vivien S Piccin; Christiane Calciolari; Kelly Yoshizaki; Susimeire Gomes; Cláudia Albertini-Yagi; Marisa Dolhnikoff; Mariângela Macchione; Elia G Caldini; Paulo H N Saldiva; Elnara M Negri
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-10-28
Journal Detail:
Title:  Intensive care medicine     Volume:  37     ISSN:  1432-1238     ISO Abbreviation:  Intensive Care Med     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  132-40     Citation Subset:  IM    
Affiliation:
Department of Pathology, University of São Paulo School of Medicine, São Paulo, Brazil. vspiccin@uol.com.br
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Comment In:
Intensive Care Med. 2011 Jan;37(1):4-6   [PMID:  20981408 ]

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