Effect of mechanical ventilation versus spontaneous breathing on abdominal edema and inflammation in ARDS: an experimental porcine model.
Abdomen
/ pathology
Animals
Ascites
/ blood
Continuous Positive Airway Pressure
Disease Models, Animal
Edema
/ blood
Inflammation
/ blood
Interleukin-6
/ blood
Male
Random Allocation
Respiration
Respiration, Artificial
/ adverse effects
Respiratory Distress Syndrome
/ pathology
Swine
Tumor Necrosis Factor-alpha
/ blood
ARDS
Abdominal inflammation
Cytokines
Edema
Mechanical ventilation
Spontaneous ventilation
Journal
BMC pulmonary medicine
ISSN: 1471-2466
Titre abrégé: BMC Pulm Med
Pays: England
ID NLM: 100968563
Informations de publication
Date de publication:
25 Apr 2020
25 Apr 2020
Historique:
received:
23
08
2019
accepted:
07
04
2020
entrez:
27
4
2020
pubmed:
27
4
2020
medline:
26
1
2021
Statut:
epublish
Résumé
Mechanical ventilation (MV), compared to spontaneous breathing (SB), has been found to increase abdominal edema and inflammation in experimental sepsis. Our hypothesis was that in primary acute respiratory distress syndrome (ARDS) MV would enhance inflammation and edema in the abdomen. Thirteen piglets were randomized into two groups (SB and MV) after the induction of ARDS by lung lavage and 1 h of injurious ventilation. 1. SB: continuous positive airway pressure 15 cmH abdominal edema, assessed by tissues histopathology and wet-dry weight; abdominal inflammation, assessed by cytokine concentration in tissues, blood and ascites, and tissue histopathology. The groups did not show significant differences in hemodynamic or respiratory parameters. Moreover, edema and inflammation in the abdominal organs were similar. However, blood IL6 increased in the MV group in all vascular beds (p < 0.001). In addition, TNFα ratio in blood increased through the lungs in MV group (+ 26% ± 3) but decreased in the SB group (- 17% ± 3). There were no differences between the MV and SB group for abdominal edema or inflammation. However, the systemic increase in IL6 and the TNFα increase through the lungs suggest that MV, in this model, was harmful to the lungs.
Sections du résumé
BACKGROUND
BACKGROUND
Mechanical ventilation (MV), compared to spontaneous breathing (SB), has been found to increase abdominal edema and inflammation in experimental sepsis. Our hypothesis was that in primary acute respiratory distress syndrome (ARDS) MV would enhance inflammation and edema in the abdomen.
METHODS
METHODS
Thirteen piglets were randomized into two groups (SB and MV) after the induction of ARDS by lung lavage and 1 h of injurious ventilation. 1. SB: continuous positive airway pressure 15 cmH
MAIN OUTCOMES
RESULTS
abdominal edema, assessed by tissues histopathology and wet-dry weight; abdominal inflammation, assessed by cytokine concentration in tissues, blood and ascites, and tissue histopathology.
RESULTS
RESULTS
The groups did not show significant differences in hemodynamic or respiratory parameters. Moreover, edema and inflammation in the abdominal organs were similar. However, blood IL6 increased in the MV group in all vascular beds (p < 0.001). In addition, TNFα ratio in blood increased through the lungs in MV group (+ 26% ± 3) but decreased in the SB group (- 17% ± 3).
CONCLUSIONS
CONCLUSIONS
There were no differences between the MV and SB group for abdominal edema or inflammation. However, the systemic increase in IL6 and the TNFα increase through the lungs suggest that MV, in this model, was harmful to the lungs.
Identifiants
pubmed: 32334550
doi: 10.1186/s12890-020-1138-6
pii: 10.1186/s12890-020-1138-6
pmc: PMC7183610
doi:
Substances chimiques
Interleukin-6
0
Tumor Necrosis Factor-alpha
0
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
106Subventions
Organisme : CSRD VA
ID : 1
Pays : United States
Organisme : Swedish Research Council
ID : 2
Organisme : Uppsala Universitet (SE)
ID : 3
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