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- Nyberg, AxelUppsala universitet,Centrum för klinisk forskning i Sörmland (CKFD),Klinisk kemi (author)
Lung-protective ventilation increases cerebral metabolism and non-inflammatory brain injury in porcine experimental sepsis
- Article/chapterEnglish2021
Publisher, publication year, extent ...
- 2021-04-29
- BioMed Central (BMC),2021
- electronicrdacarrier
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- LIBRIS-ID:oai:DiVA.org:uu-443000
- https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-443000URI
- https://doi.org/10.1186/s12868-021-00629-0DOI
- http://kipublications.ki.se/Default.aspx?queryparsed=id:146423157URI
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- Language:English
- Summary in:English
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- BACKGROUND: Protective ventilation with lower tidal volumes reduces systemic and organ-specific inflammation. In sepsis-induced encephalopathy or acute brain injury the use of protective ventilation has not been widely investigated (experimentally or clinically). We hypothesized that protective ventilation would attenuate cerebral inflammation in a porcine endotoxemic sepsis model. The aim of the study was to study the effect of tidal volume on cerebral inflammatory response, cerebral metabolism and brain injury. Nine animals received protective mechanical ventilation with a tidal volume of 6 mL × kg-1 and nine animals were ventilated with a tidal volume of 10 mL × kg-1. During a 6-h experiment, the pigs received an endotoxin intravenous infusion of 0.25 µg × kg-1 × h-1. Systemic, superior sagittal sinus and jugular vein blood samples were analysed for inflammatory cytokines and S100B. Intracranial pressure, brain tissue oxygenation and brain microdialysis were sampled every hour.RESULTS: No differences in systemic or sagittal sinus levels of TNF-α or IL-6 were seen between the groups. The low tidal volume group had increased cerebral blood flow (p < 0.001) and cerebral oxygen delivery (p < 0.001), lower cerebral vascular resistance (p < 0.05), higher cerebral metabolic rate (p < 0.05) along with higher cerebral glucose consumption (p < 0.05) and lactate production (p < 0.05). Moreover, low tidal volume ventilation increased the levels of glutamate (p < 0.01), glycerol (p < 0.05) and showed a trend towards higher lactate to pyruvate ratio (p = 0.08) in cerebral microdialysate as well as higher levels of S-100B (p < 0.05) in jugular venous plasma compared with medium-high tidal volume ventilation.CONCLUSIONS: Contrary to the hypothesis, protective ventilation did not affect inflammatory cytokines. The low tidal volume group had increased cerebral blood flow, cerebral oxygen delivery and cerebral metabolism together with increased levels of markers of brain injury compared with medium-high tidal volume ventilation.
Subject headings and genre
- MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Anestesi och intensivvård hsv//swe
- MEDICAL AND HEALTH SCIENCES Clinical Medicine Anesthesiology and Intensive Care hsv//eng
- Biomarkers
- Endotoxin
- Innate immunity
- Microdialysis
- Tidal volume
Added entries (persons, corporate bodies, meetings, titles ...)
- Gremo, ErikUppsala universitet,Centrum för klinisk forskning i Sörmland (CKFD) (author)
- Blixt, JonasKarolinska Institutet (author)
- Sperber, JesperUppsala universitet,Centrum för klinisk forskning i Sörmland (CKFD),Infektionsmedicin(Swepub:uu)jessp997 (author)
- Larsson, AndersUppsala universitet,Klinisk kemi(Swepub:uu)andlarss (author)
- Lipcsey, MiklósUppsala universitet,Hedenstiernalaboratoriet,Anestesiologi och intensivvård(Swepub:uu)milip123 (author)
- Pikwer, AndreasUppsala universitet,Institutionen för medicinska vetenskaper,Centrum för klinisk forskning i Sörmland (CKFD)(Swepub:uu)andpi520 (author)
- Castegren, Markus,1976-Karolinska Institutet,Uppsala universitet,Centrum för klinisk forskning i Sörmland (CKFD),Infektionsmedicin,Perioperative Medicine and Intensive Care (PMI), Karolinska University Hospital, Stockholm, Sweden.;The Department of Physiology and Pharmacology (FyFa), Karolinska Institute, Stockholm, Sweden.;Department of Anaesthesiology & Intensive Care, Centre for Clinical Research, Sörmland, Mälarsjukhuset, 631 88, Eskilstuna, Sweden.(Swepub:uu)marca458 (author)
- Uppsala universitetCentrum för klinisk forskning i Sörmland (CKFD) (creator_code:org_t)
Related titles
- In:BMC Neuroscience: BioMed Central (BMC)221471-2202
Internet link
- https://doi.org/10.1186/s12868-021-00629-0Fulltext
- https://uu.diva-portal.org/smash/get/diva2:1556566/FULLTEXT01.pdffulltext:print
- https://bmcneurosci.biomedcentral.com/track/pdf/10.1186/s12868-021-00629-0
- https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-443000
- https://doi.org/10.1186/s12868-021-00629-0
- http://kipublications.ki.se/Default.aspx?queryparsed=id:146423157
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