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Time and tidal volume-dependent ventilator-induced lung injury in healthy rats

Published online by Cambridge University Press:  15 September 2005

B. Walder ,
F. Fontao ,
M. Tötsch  and
D. R. Morel
B. Walder
Affiliation:
University Hospitals of Geneva, Division of Anesthesiological Investigations, Geneva, Switzerland
F. Fontao
Affiliation:
University Hospitals of Geneva, Division of Anesthesiological Investigations, Geneva, Switzerland
M. Tötsch
Affiliation:
University Hospital, Institute of Pathology, Essen, Germany
D. R. Morel
Affiliation:
University Hospitals of Geneva, Division of Anesthesiological Investigations, Geneva, Switzerland
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Summary

Background and objective: We evaluated the effect of duration of mechanical ventilation with different tidal volumes (VT) on ventilator-induced lung injury in healthy rats. Methods: Anaesthetized rats were ventilated with VT between 9 and 45 mL kg−1 for 1 or 7 h with a positive end-expiratory pressure of 2.5 cmH2O. Results: After 1 h, rats ventilated even with the highest applied VT (36 and 45 mL kg−1, resulting in average peak airway pressures of 30 ± 3 and 37 ± 4 cmH2O), had no detectable alterations in dynamic or static lung mechanics, gas exchange or pulmonary permeability, but a moderate degree of lung inflammation (neutrophil accumulation in broncho-alveolar lavage) observed in all groups. In contrast, after 3 h of ventilation, rats ventilated with the highest VT (36 and 45 mL kg−1) died from progressive circulatory failure and high-permeability pulmonary oedema, manifested by hypoxaemia, an increased alveolar–arterial protein concentration ratio and a reduced static lung compliance (mortality rate at 7 h, 62.5% and 100%). Animals with lower VT all survived and presented no changes in the measured variables. Conclusion: These results in normal rats demonstrate the preponderant effect of the duration (>3 h) of ‘aggressive’ ventilation and the cut-off value of the level of VT applied (>27 mL kg−1).

Keywords

POSITIVE PRESSURE RESPIRATION, tidal volume, airway pressureLUNG COMPLIANCEMODEL, ANIMAL, ratBRONCHO-ALVEOLAR LAVAGE FLUID, protein, neutrophilsRESPIRATORY DISTRESS SYNDROME
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 10 , October 2005 , pp. 786 - 794
Copyright
© 2005 European Society of Anaesthesiology

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References

Dreyfuss D, Soler P, Saumon G. Mechanical ventilation-induced pulmonary edema. Interaction with previous lung alterations. Am J Respir Crit Care Med 1995; 151: 1568–1575.Google Scholar
Golder FJ, Fuller DD, Davenport PW, Johnson RD, Reier PJ, Bolser DC. Respiratory motor recovery after unilateral spinal cord injury: eliminating crossed phrenic activity decreases tidal volume and increases contralateral respiratory motor output. J Neurosci 2003; 23: 2494–2501.Google Scholar
Tsuno K, Prato P, Kolobow T. Acute lung injury from mechanical ventilation at moderately high airway pressures. J Appl Physiol 1990; 69: 956–961.Google Scholar
Dreyfuss D, Saumon G. Ventilator-induced lung injury. Lessens from experimental studies. Am J Respir Crit Care Med 1998; 157: 294–323.Google Scholar
Parker JC, Hernandez LA, Peevy KJ. Mechanisms of ventilator-induced lung injury. Crit Care Med 1993; 21: 131–143.Google Scholar
Gajic O, Lee J, Doerr CH, Berrios JC, Myers JL, Hubmayr RD. Ventilator-induced cell wounding and repair in the intact lung. Am J Respir Crit Care Med 2003; 167: 1057–1063.Google Scholar
Nahum A, Hoyt J, Schmitz L, Moody J, Shapiro R, Marini JJ. Effect of mechanical ventilation strategy on dissemination of intratracheally instilled Escherichia coli in dogs. Crit Care Med 1997; 25: 1733–1743.Google Scholar
Muscedere JG, Mullen JB, Gan K, Slutsky AS. Tidal ventilation at low airway pressures can augment lung injury. Am J Respir Crit Care Med 1994; 149: 1327–1334.Google Scholar
Belperio JA, Keane MP, Burdick MD et al. Critical role for CXCR2 and CXCR2 ligands during the pathogenesis of ventilator-induced lung injury. J Clin Invest 2002; 110: 1703–1716.Google Scholar
Anzueto A, Peters JI, Tobin MJ et al. Effects of prolonged controlled mechanical ventilation on diaphragmatic function in healthy adult baboons. Crit Care Med 1997; 25: 1187–1190.Google Scholar
Simonson SG, Huang YC, Fracica PJ et al. Changes in the lung after prolonged positive pressure ventilation in normal baboons. J Crit Care 1997; 12: 72–82.Google Scholar
Goldstein I, Bughalo MT, Marquette CH, Lenaour G, Lu Q, Rouby JJ. Mechanical ventilation-induced air-space enlargement during experimental pneumonia in piglets. Am J Respir Crit Care Med 2001; 163: 958–964.Google Scholar
Le Bourdelles G, Viires N, Boczkowski J, Seta N, Pavlovic D, Aubier M. Effects of mechanical ventilation on diaphragmatic contractile properties in rats. Am J Respir Crit Care Med 1994; 149: 1539–1544.Google Scholar
Behnia R, Molteni A, Waters CM et al. Early markers of ventilator-induced lung injury in rats. Ann Clin Lab Sci 1996; 26: 437–450.Google Scholar
Cilley RE, Wang JY, Coran AG. Lung injury produced by moderate lung overinflation in rats. J Pediatr Surg 1993; 28: 488–493.Google Scholar
Lai YL, Diamond L. Comparison of five methods of analyzing respiratory pressure–volume curves. Respir Physiol 1986; 66: 147–155.Google Scholar
Venegas JG, Harris RS, Simon BA. A comprehensive equation for the pulmonary pressure–volume curve. J Appl Physiol 1998; 84: 389–395.Google Scholar
Capron F. Lavage broncho-alvéolaire. Arch Anat Cytol Path 1997; 45: 255–260.Google Scholar
Walder B, Brundler MA, Totsch M, Elia N, Morel DR. Influence of the type and rate of subarachnoid fluid infusion on lethal neurogenic pulmonary edema in rats. J Neurosurg Anesthesiol 2002; 14: 194–203.Google Scholar
Schneuwly OD, Licker M, Pastor CM et al. Beneficial effects of leukocyte-depleted blood and low-potassium dextran solutions on microvascular permeability in preserved porcine lung. Am J Respir Crit Care Med 1999; 160: 689–697.Google Scholar
Dreyfuss D, Saumon G. Role of tidal volume, FRC, and end-inspiratory volume in the development of pulmonary edema following mechanical ventilation. Am Rev Respir Dis 1993; 148: 1194–1203.Google Scholar
Fu Z, Costello ML, Tsukimoto K et al. High lung volume increases stress failure in pulmonary capillaries. J Appl Physiol 1992; 73: 123–133.Google Scholar
Martin-Lefevre L, Ricard JD, Roupie E, Dreyfuss D, Saumon G. Significance of the changes in the respiratory system pressure–volume curve during acute lung injury in rats. Am J Respir Crit Care Med 2001; 164: 627–632.Google Scholar
Albaiceta GM, Taboada F, Parra D, Blanco A, Escudero D, Otero J. Differences in the deflation limb of the pressure– volume curves in acute respiratory distress syndrome from pulmonary and extrapulmonary origin. Intens Care Med 2003; 29: 1943–1949.Google Scholar
Imanaka H, Shimaoka M, Matsuura N, Nishimura M, Ohta N, Kiyono H. Ventilator-induced lung injury is associated with neutrophil infiltration, macrophage activation, and TGF-beta 1 mRNA upregulation in rat lungs. Anesth Analg 2001; 92: 428–436.Google Scholar
Dreyfuss D, Soler P, Basset G, Saumon G. High inflation pressure pulmonary edema. Respective effects of high airway pressure, high tidal volume, and positive end-expiratory pressure. Am Rev Respir Dis 1988; 137: 1159–1164.Google Scholar
Schiller HJ, McCann II UG, Carney DE, Gatto LA, Steinberg JM, Nieman GF. Altered alveolar mechanics in the acutely injured lung. Crit Care Med 2001; 29: 1049–1055.Google Scholar
Tsuno K, Miura K, Takeya M, Kolobow T, Morioka T. Histopathologic pulmonary changes from mechanical ventilation at high peak airway pressures. Am Rev Respir Dis 1991; 143: 1115–1120.Google Scholar
Hotchkiss Jr JR, Blanch L, Murias G et al. Effects of decreased respiratory frequency on ventilator-induced lung injury. Am J Respir Crit Care Med 2000; 161: 463–468.Google Scholar
Rich PB, Reickert CA, Sawada S et al. Effect of rate and inspiratory flow on ventilator-induced lung injury. J Trauma 2000; 49: 903–911.Google Scholar
Putensen C, Zech S, Wrigge H et al. Long-term effects of spontaneous breathing during ventilatory support in patients with acute lung injury. Am J Respir Crit Care Med 2001; 164: 43–49.Google Scholar