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High respiratory ra...
High respiratory rate is associated with early reduction of lung edema clearance in an experimental model of ARDS
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- Retamal, Jaime (author)
- Uppsala universitet,Anestesiologi och intensivvård
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- Borges, Joao Batista (author)
- Uppsala universitet,Hedenstiernalaboratoriet
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Bruhn, A (author)
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- Cao, Xiaofang (author)
- Uppsala universitet,Institutionen för medicinsk biokemi och mikrobiologi,Staffan Johansson
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Feinstein, R (author)
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- Hedenstierna, Göran (author)
- Uppsala universitet,Klinisk fysiologi
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- Johansson, Staffan (author)
- Uppsala universitet,Institutionen för medicinsk biokemi och mikrobiologi,Staffan Johansson
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- Suarez-Sipmann, Fernando (author)
- Uppsala universitet,Hedenstiernalaboratoriet
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- Larsson, Anders (author)
- Uppsala universitet,Hedenstiernalaboratoriet
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(creator_code:org_t)
- 2015-08-10
- 2016
- English.
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In: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 60:1, s. 79-92
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- BACKGROUND: The independent impact of respiratory rate on ventilator-induced lung injury has not been fully elucidated. The aim of this study was to investigate the effects of two clinically relevant respiratory rates on early ventilator-induced lung injury evolution and lung edema during the protective ARDSNet strategy. We hypothesized that the use of a higher respiratory rate during a protective ARDSNet ventilation strategy increases lung inflammation and, in addition, lung edema associated to strain-induced activation of transforming growth factor beta (TGF-β) in the lung epithelium.METHODS: Twelve healthy piglets were submitted to a two-hit lung injury model and randomized into two groups: LRR (20 breaths/min) and HRR (40 breaths/min). They were mechanically ventilated during 6 h according to the ARDSNet strategy. We assessed respiratory mechanics, hemodynamics, and extravascular lung water (EVLW). At the end of the experiment, the lungs were excised and wet/dry ratio, TGF-β pathway markers, regional histology, and cytokines were evaluated.RESULTS: No differences in oxygenation, PaCO2 levels, systemic and pulmonary arterial pressures were observed during the study. Respiratory system compliance and mean airway pressure were lower in LRR group. A decrease in EVLW over time occurred only in the LRR group (P < 0.05). Wet/dry ratio was higher in the HRR group (P < 0.05), as well as TGF-β pathway activation. Histological findings suggestive of inflammation and inflammatory tissue cytokines were higher in LRR.CONCLUSION: HRR was associated with more pulmonary edema and higher activation of the TGF-β pathway. In contrast with our hypothesis, HRR was associated with less lung inflammation.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Keyword
- Anaesthesiology and Intensive Care
- Anestesiologi och intensivvård
Publication and Content Type
- ref (subject category)
- art (subject category)
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