Document Detail

Effects of surfactant replacement on alveolar overdistension and plasma cytokines in ventilator-induced lung injury.
MedLine Citation:
PMID:  19764904     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Overdistension of the lung causes ventilator-induced lung injury (VILI) accompanied by surfactant abnormalities and inflammatory changes. We investigated the effects of surfactant replacement on overdistension of the terminal airspaces and plasma cytokine levels in VILI. METHODS: VILI was induced by high-pressure ventilation (HPV) in rats anesthetized with pentobarbital, followed by ventilation for 2 h in the maintenance mode (tidal volume=10 ml/kg, positive end-expiratory pressure = 7.5 cmH(2)O) with or without surfactant replacement. The sizes of the terminal airspaces were determined after fixing the lungs at an airway pressure of 10 cmH(2)O on deflation. Cytokine levels were assessed by enzyme-linked immunosorbent assay. RESULTS: The mean ratio of the largest terminal airspace size class (> or = 64,000 microm(2)) was increased from 13.4% to 32.0% by HPV (P<0.05). After maintenance-mode ventilation, the ratio decreased to 16.1% with surfactant replacement (P<0.05), but increased to 44.6% without surfactant replacement (P<0.05). Mean macrophage inflammatory protein-2 (MIP-2) levels in the plasma increased from <0.02 to 6.9 ng/ml with HPV (P<0.05), and further increased to > or = 11.8 ng/ml, regardless of surfactant replacement after maintenance-mode ventilation. Similar tendencies were observed in the interleukin (IL)-6 and IL-10 levels. Tumor necrosis factor-alpha levels were almost negligible during the experiment. CONCLUSION: In rats with VILI, surfactant replacement reversed overdistension of the terminal airspaces that may induce barotrauma, but not upregulation of MIP-2, IL-6, and IL-10 within 2 h.
H Wu; T Kobayashi; Q Wan; W Shi; H Qian; X Cui; W Li
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Publication Detail:
Type:  Journal Article     Date:  2009-09-17
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  54     ISSN:  1399-6576     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-04-26     Completed Date:  2010-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  354-61     Citation Subset:  IM    
Department of Anesthesiology, Second Affiliated Hospital, Harbin Medical University, Harbin 150086, China.
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MeSH Terms
Acute Lung Injury / etiology*,  pathology
Carbon Dioxide / blood
Chemokine CXCL2 / blood
Cytokines / blood*
High-Frequency Ventilation / adverse effects*
Interleukin-10 / blood
Interleukin-6 / blood
Oxygen / blood
Positive-Pressure Respiration
Pulmonary Alveoli / injuries*
Pulmonary Gas Exchange / drug effects
Pulmonary Surfactants / pharmacology*
Rats, Wistar
Ventilators, Mechanical / adverse effects*
Reg. No./Substance:
0/Chemokine CXCL2; 0/Cxcl2 protein, rat; 0/Cytokines; 0/Interleukin-6; 0/Pulmonary Surfactants; 124-38-9/Carbon Dioxide; 130068-27-8/Interleukin-10; 7782-44-7/Oxygen

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