The influence of continuous positive pressure ventilation on the degree of inflammatory reaction and organ function – experimental study
Authors:
Kobr Jiří 1; Fremuth Jiří 1; Pizingerová Kateřina 1; Fikrlová Šárka 1; Jehlička Petr 1; Honomichl Petr 1; Šašek Lumír 1; Racek Jaroslav 2; Topolčan Ondřej 3
Authors place of work:
Dětská klinika JIP, LF UK v Plzni a FN v Plzni
1; Ústav klinické biochemie a hematologie, LF UK v Plzni a FN v Plzni
2; Oddělení imunoanalytické diagnostiky, LF UK v Plzni a FN v Plzni
3
Published in the journal:
Anest. intenziv. Med., 20, 2009, č. 2, s. 88-95
Category:
Intensive Care Medicine - Original Paper
Summary
Objective:
Assessment of the functioning of extra-pulmonary organs during the ventilation of healthy lungs.
Type of study:
Experimental, comparative.
Setting:
Experimental Centre of the University Hospital.
Materials and methods:
15 white piglets weighing 22.7 (18.8–27) kg were identically instrumentated and monitored under general anaesthesia and divided into three equal groups. The pigs in Group A breathed spontaneously, group B pigs were ventilated with VT 6 ml . kg-1 and group C pigs were ventilated with VT 10 ml . kg-1. Measurements and samplings were performed in all the animal groups in the first hour and in groups B and C at 12 hours. The data were compared in groups and between groups, they were statistically analyzed and considered significantly different when p < 0.05.
Results:
The levels of soluble adhesion molecules, left ventricular contractility, FeNa, GFI and Cfw were found to be higher in groups B and C compared with group A in the first hour of the study. Higher levels of inflammatory mediators and BNP, and lower right ventricular performance and Cfw were observed in group C compared to group B. At 12 hours a decline in the ventricular performance and a reduction of inflammatory mediator expression were observed in groups B and C and a reduction of Cfw was observed in group C. Higher values of OI and VI and lower ventricular performance, PaO2/FiO2, Cfw and hourly urine output were found in group C compared to group B.
Conclusions:
The results support the hypothesis that mechanical ventilation of healthy lungs activates early inflammatory response. The neuro-humoral regulation and stabilization of other organs’ function are temporary. Mechanical ventilation with VT 10 ml . kg-1 reduces the treatment effect and its prolonged use has an adverse impact on extra-pulmonary organs.
Keywords:
mechanical ventilation – inflammatory reaction, neuro-humoral regulation – cardiac performance – renal function
Zdroje
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Štítky
Anaesthesiology, Resuscitation and Inten Intensive Care MedicineČlánok vyšiel v časopise
Anaesthesiology and Intensive Care Medicine
2009 Číslo 2
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