Document Detail


Ventilation strategies affect surfactant aggregate conversion in acute lung injury.
MedLine Citation:
PMID:  9032184     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study evaluated the effects of varying tidal volumes (VT) and positive end-expiratory pressure (PEEP) levels on surfactant aggregate conversion and lung function in an animal model of lung injury induced by N-nitroso-N-methylurethane. Lung-injured adult rabbits were initially ventilated using a VT of 10 ml/kg (VT10), a respiratory rate of 30 breaths/min (RR30), and a PEEP of 3.5 cm H2O. A trace dose of radiolabeled rabbit large surfactant aggregates was instilled after the onset of ventilation, and animals were then ventilated at different ventilator settings for 1 h. Ventilation strategies involving a lower VT (VT5, RR60) resulted in significantly superior oxygenation and lower surfactant aggregate conversion rates than strategies involving a higher VT ([VT10, RR30], [VT15, RR20], p < 0.05). Increasing the PEEP level to 8.0 cm H2O improved oxygenation, but it was sustained only with a low VT (VT5, RR60), and deteriorated with a high VT (VT10, RR30). Varying VT but not PEEP levels resulted in significant changes in surfactant aggregate conversion. We conclude that increased surfactant aggregate conversion resulting from suboptimal ventilation of injured lungs may play an important role in the pathophysiology of ventilation-induced lung dysfunction in acute lung injury.
Authors:
Y Ito; R A Veldhuizen; L J Yao; L A McCaig; A J Bartlett; J F Lewis
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  155     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  1997 Feb 
Date Detail:
Created Date:  1997-03-11     Completed Date:  1997-03-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  493-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, University of Western Ontario, London, Canada.
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MeSH Terms
Descriptor/Qualifier:
Animals
Carcinogens / toxicity
Cell Aggregation
Hydrogen-Ion Concentration
Lung Diseases / chemically induced,  physiopathology*
Nitrosomethylurethane / toxicity
Phospholipids / metabolism
Positive-Pressure Respiration*
Pulmonary Gas Exchange
Pulmonary Surfactants / analysis,  metabolism*
Rabbits
Tidal Volume
Chemical
Reg. No./Substance:
0/Carcinogens; 0/Phospholipids; 0/Pulmonary Surfactants; 615-53-2/Nitrosomethylurethane

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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