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Increased Alveolar ...
Increased Alveolar Damage after Mechanical Ventilation in a Porcine Model of Thoracic Surgery
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- Kozian, Alf, 1969- (författare)
- Uppsala universitet,Klinisk fysiologi
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- Schilling, Thomas, 1966- (författare)
- Uppsala universitet,Klinisk fysiologi
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- Röcken, Christoph (författare)
- Institute of Pathology, Charité University Hospital, Berlin, Germany
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- Breitling, Christian (författare)
- Dept. of Anaesthesiology and Intensive Care Medicine, Otto-von-Guericke-University Magdeburg, Germany
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- Hachenberg, Thomas (författare)
- Department of Anesthesiology and Intensive Care Medicine, Otto-von-Guericke-University Magdeburg, Germany
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- Hedenstierna, Göran (författare)
- Uppsala universitet,Klinisk fysiologi
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(creator_code:org_t)
- Elsevier BV, 2010
- 2010
- Engelska.
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Ingår i: Journal of Cardiothoracic and Vascular Anesthesia. - : Elsevier BV. - 1053-0770 .- 1532-8422. ; 24:4, s. 617-623
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Objective: Mechanical stress during one-lung ventilation (OLV) results in lung injury. This experiment compares effects of mechanical ventilation, OLV and surgical manipulation on diffuse alveolar damage (DAD) after application of different anesthetic regimes. Design: Prospective, randomized, controlled, blinded animal experiment. Setting: University hospital. Objects: Twenty-one piglets. Interventions: Animals (27.5kg) were randomized into four groups: spontaneous breathing (SB, n=3); two-lung ventilation (TLV, n=6); OLV during desflurane (n=6) and propofol anesthesia (n=6). SB pigs were killed after induction of anesthesia. Lung tissue samples were analyzed to obtain reference values for alveolar damage. TLV pigs underwent standard TLV (VT=10ml/kg, FIO2=0.40, PEEP=5cmH2O). In OLV pigs, after lung separation by a bronchial blocker, OLV (VT=10ml/kg) and thoracic surgery were performed. After the procedure the pigs were killed. Lung tissue samples were harvested for histological examination. Lung injury was quantified by DAD score; sequestration of leukocytes was assessed by recruitment of CD45+-cells into the lungs. Main Results: TLV resulted in increased DAD scores in both lungs (TLV vs. SB: 6.9 vs. 2.7; p<0.05); the number of CD45+-cells was not increased (TLV vs. SB: 8.7 vs. 5.0 cells/view). OLV and surgical manipulation increased DAD and leukocyte sequestration without differences between the ventilated and manipulated lungs. Leukocyte recruitment was not differently affected by the anesthetic regimen (propofol vs. desflurane: CD45+-cells/view: 13.5 vs. 11.3). Conclusions: TLV resulted in increased DAD scores in the lungs as compared with SB. OLV and thoracic surgery further increased lung injury and leukocyte recruitment independently of the administration of propofol or desflurane anesthesia.
Nyckelord
- One-Lung Ventilation
- Open Thoracic Surgery
- Ventilator-Induced Lung Injury
- Diffuse Alveolar Damage
- Pulmonary Leukocyte Recruitment
- General Anesthesia
- MEDICINE
- MEDICIN
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- art (ämneskategori)
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