| Influence of lung mechanical properties and alveolar architecture on the pathogenesis of ischemia-reperfusion injury. | |
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MedLine Citation:
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PMID: 20378696 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We tested the hypothesis that lung preservation techniques disarrange lung architecture, increase pulmonary impedance and lead to ischemia-reperfusion injury, which can be prevented by re-establishment of optimal lung geometry. In the first phase, fresh, cold ischemic, preserved lungs insufflated to total lung capacity (TLC) and preserved lungs ventilated with tidal volume prior to reperfusion were submitted to a 60-min ex-vivo reperfusion to evaluate the gas exchange, pulmonary hemodynamic and lung mechanics' properties. In the second phase, we evaluated the mechanical properties of lungs submitted to the same conditions of the first phase. Cold ischemic lungs developed fulminant edema during the first 15 min of ex-vivo reperfusion, whereas gas exchange, hemodynamic and mechanic properties of lungs insufflated to TLC and ventilated during 10 min prior to reperfusion were similar to fresh lungs. After the pulmonary vascular flush pulmonary impedance and alveolar collapsed area increased significantly. The insufflation to TLC and 10 min of tidal ventilation reduced the lung impedance and the percentage of alveolar collapsed area. Lung preservation techniques disarrange alveolar architecture, which lead to ischemia-reperfusion injury; recruitment maneuvers decrease the pulmonary inhomogeneities and protect the lungs against the ischemia-reperfusion injury. |
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Authors:
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César Augusto Melo Silva; Rodrigo Storck Carvalho; Viviane Ramos Cagido; Walter Araújo Zin; Paulo Tavares; Kleber Nogueira DeCampos |
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Publication Detail:
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Type: Journal Article Date: 2010-04-08 |
Journal Detail:
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Title: Interactive cardiovascular and thoracic surgery Volume: 11 ISSN: 1569-9285 ISO Abbreviation: Interact Cardiovasc Thorac Surg Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-06-21 Completed Date: 2010-10-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101158399 Medline TA: Interact Cardiovasc Thorac Surg Country: England |
Other Details:
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Languages: eng Pagination: 46-51 Citation Subset: IM |
Affiliation:
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Laboratory of Respiratory Physiology, University of Brasília, Brasília, DF, Brazil. camelo@me.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Cold Ischemia / adverse effects* Insufflation Lung / blood supply, pathology*, physiopathology*, surgery Lung Diseases / etiology, pathology, physiopathology, prevention & control* Lung Transplantation* Male Positive-Pressure Respiration Pulmonary Alveoli / pathology, physiopathology Pulmonary Circulation Pulmonary Edema / etiology Pulmonary Gas Exchange Rats Rats, Wistar Reperfusion / adverse effects* Reperfusion Injury / etiology, pathology, physiopathology, prevention & control* Respiration, Artificial* / methods Respiratory Mechanics Tidal Volume Time Factors Total Lung Capacity |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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