| Kinetic and reversibility of mechanical ventilation-associated pulmonary and systemic inflammatory response in patients with acute lung injury. | |
| | |
MedLine Citation:
|
PMID: 12122519 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To investigate the kinetic and reversibility of mechanical ventilation-associated pulmonary and systemic inflammatory response in patients with acute lung injury (ALI). DESIGN: Prospective observational cross-over study. SETTING: Intensive care unit of a university hospital. PATIENTS: Twelve mechanically ventilated patients with ALI. INTERVENTIONS: Mechanical ventilation was transiently changed from a lung protective setting with PEEP of 15 cmH(2)O and a V(T) of 5 ml/kg predicted body weight to a more conventional ventilatory setting with PEEP of 5 cmH(2)O and V(T) of 12 ml/kg predicted body weight for a period of 6 h. MEASUREMENTS AND RESULTS: We examined the profile of interleukin (IL)-1beta, IL-1 receptor antagonist, IL-6, IL-10, and tumor necrosis factor in the plasma of all patients, and in the bronchoalveolar lavage (mini-BAL) fluid of six of these patients. Measurements were performed at baseline, 1 h, and 6 h after each change of the ventilatory setting. Switching to conventional mechanical ventilation was associated with a higher PaO(2) ( P < 0.05) and a marked increase ( P < 0.05) of measured plasma cytokines in patients with and without mini-BAL with a maximum after 1 h. Similarly, intraalveolar cytokine concentrations increased with conventional mechanical ventilation. While plasma cytokine levels returned to baseline values, intraalveolar cytokine concentrations further increased when lung protective mechanical ventilation was reestablished. CONCLUSIONS: In patients with ALI, initiation of low PEEP and high V(T) mechanical ventilation is associated with cytokine release into circulation which occurred within 1 h. It is independent from BAL procedures and can be reversed by reinstitution of lung protective mechanical ventilation. |
| | |
Authors:
|
F Stüber; H Wrigge; S Schroeder; S Wetegrove; J Zinserling; A Hoeft; C Putensen |
Related Documents
:
|
22580619 - Optical coherence tomography for biofilm detection in chronic rhinosinusitis with nasal... 7599839 - Serum surfactant protein-a levels in patients with acute cardiogenic pulmonary edema an... 138369 - Spontaneous recovery from nondepolarizing neuromuscular blockade: correlation between c... 457589 - Allergenic significance of some fungi prevailing in the respiratory tract of allergy pa... 9925079 - Blast lung injury from an explosion on a civilian bus. 16804629 - Involvement of central airways in vibroacoustic disease patients. 1869889 - How to identify psychogenic disorders of stance and gait. a video study in 37 patients. 22618889 - Comparison of diagnostic accuracy between three different rules of interpreting high se... 23564409 - Autoantibodies against complement c1q in patients with behcet's disease: association wi... |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2002-06-15 |
Journal Detail:
|
Title: Intensive care medicine Volume: 28 ISSN: 0342-4642 ISO Abbreviation: Intensive Care Med Publication Date: 2002 Jul |
Date Detail:
|
Created Date: 2002-07-17 Completed Date: 2002-11-29 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 7704851 Medline TA: Intensive Care Med Country: United States |
Other Details:
|
Languages: eng Pagination: 834-41 Citation Subset: IM |
Affiliation:
|
Department of Anesthesiology and Intensive Care Medicine, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Bronchoalveolar Lavage Fluid Cross-Over Studies Germany Humans Inflammation Mediators / blood, metabolism Intensive Care Units Pneumonia / etiology*, physiopathology Positive-Pressure Respiration / adverse effects* Prospective Studies Respiratory Distress Syndrome, Adult / therapy* Systemic Inflammatory Response Syndrome / etiology*, physiopathology Ventilators, Mechanical / adverse effects* |
| Chemical | |
Reg. No./Substance:
|
0/Inflammation Mediators |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Clinical implications of antibiotic-induced endotoxin release in septic shock.
Next Document: The upper inflection point of the pressure-volume curve. Influence of methodology and of different m...