| Mild endotoxemia during mechanical ventilation produces spatially heterogeneous pulmonary neutrophilic inflammation in sheep. | |
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MedLine Citation:
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PMID: 20179503 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: There is limited information on the regional inflammatory effects of mechanical ventilation and endotoxemia on the production of acute lung injury. Measurement of F-fluorodeoxyglucose (F-FDG) uptake with positron emission tomography allows for the regional, in vivo and noninvasive, assessment of neutrophilic inflammation. The authors tested whether mild endotoxemia combined with large tidal volume mechanical ventilation bounded by pressures within clinically acceptable limits could yield measurable and anatomically localized neutrophilic inflammation. METHODS: Sheep were mechanically ventilated with plateau pressures = 30-32 cm H2O and positive end-expiratory pressure = 0 for 2 h. Six sheep received intravenous endotoxin (10 ng x kg x min), whereas six did not (controls), in sequentially performed studies. The authors imaged with positron emission tomography the intrapulmonary kinetics of infused N-nitrogen and F-FDG to compute regional perfusion and F-FDG uptake. Transmission scans were used to assess aeration. RESULTS: Mean gas fraction and perfusion distribution were similar between groups. In contrast, a significant increase in F-FDG uptake was observed in all lung regions of the endotoxin group. In this group, F-FDG uptake in the middle and dorsal regions was significantly larger than that in the ventral regions. Multivariate analysis showed that the F-FDG uptake was associated with regional aeration (P < 0.01) and perfusion (P < 0.01). CONCLUSIONS: Mild short-term endotoxemia in the presence of heterogeneous lung aeration and mechanical ventilation with pressures within clinically acceptable limits produces marked spatially heterogeneous increases in pulmonary neutrophilic inflammation. The dependence of inflammation on aeration and perfusion suggests a multifactorial basis for that finding. F-FDG uptake may be a sensitive marker of pulmonary neutrophilic inflammation in the studied conditions. |
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Authors:
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Eduardo L V Costa; Guido Musch; Tilo Winkler; Tobias Schroeder; R Scott Harris; Hazel A Jones; Jose G Venegas; Marcos F Vidal Melo |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Anesthesiology Volume: 112 ISSN: 1528-1175 ISO Abbreviation: Anesthesiology Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-02-24 Completed Date: 2010-03-30 Revised Date: 2011-07-25 |
Medline Journal Info:
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Nlm Unique ID: 1300217 Medline TA: Anesthesiology Country: United States |
Other Details:
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Languages: eng Pagination: 658-69 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesia and Critical Care, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Blood Gas Analysis Endotoxemia / pathology*, radionuclide imaging Fluorodeoxyglucose F18 / diagnostic use Inflammation / etiology, pathology*, radionuclide imaging Leukocyte Count Lung / pathology*, radionuclide imaging Neutrophils / pathology* Nitrogen Radioisotopes / diagnostic use Perfusion Pneumonia / etiology, pathology, radionuclide imaging Positive-Pressure Respiration Positron-Emission Tomography Pulmonary Circulation / physiology Radiopharmaceuticals / diagnostic use Respiration, Artificial / adverse effects* Sheep |
| Grant Support | |
ID/Acronym/Agency:
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HL 5R01HL086827/HL/NHLBI NIH HHS; K08HL076464/HL/NHLBI NIH HHS; R01 HL086717-04/HL/NHLBI NIH HHS; R01 HL086827-03/HL/NHLBI NIH HHS; R01 HL086827-05/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Nitrogen Radioisotopes; 0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18 |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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