Effects of different fluid management on lung and kidney during pressure-controlled and pressure-support ventilation in experimental acute lung injury
© 2022 The Authors. Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society..
Optimal fluid management is critical during mechanical ventilation to mitigate lung damage. Under normovolemia and protective ventilation, pulmonary tensile stress during pressure-support ventilation (PSV) results in comparable lung protection to compressive stress during pressure-controlled ventilation (PCV) in experimental acute lung injury (ALI). It is not yet known whether tensile stress can lead to comparable protection to compressive stress in ALI under a liberal fluid strategy (LF). A conservative fluid strategy (CF) was compared with LF during PSV and PCV on lungs and kidneys in an established model of ALI. Twenty-eight male Wistar rats received endotoxin intratracheally. After 24 h, they were treated with CF (minimum volume of Ringer's lactate to maintain normovolemia and mean arterial pressure ≥70 mmHg) or LF (~4 times higher than CF) combined with PSV or PCV (VT = 6 ml/kg, PEEP = 3 cmH2 O) for 1 h. Nonventilated animals (n = 4) were used for molecular biology analyses. CF-PSV compared with LF-PSV: (1) decreased the diffuse alveolar damage score (10 [7.8-12] vs. 25 [23-31.5], p = 0.006), mainly due to edema in axial and alveolar parenchyma; (2) increased birefringence for occludin and claudin-4 in lung tissue and expression of zonula-occludens-1 and metalloproteinase-9 in lung. LF compared with CF reduced neutrophil gelatinase-associated lipocalin and interleukin-6 expression in the kidneys in PSV and PCV. In conclusion, CF compared with LF combined with PSV yielded less lung epithelial cell damage in the current model of ALI. However, LF compared with CF resulted in less kidney injury markers, regardless of the ventilatory strategy.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:10 |
|---|---|
| Enthalten in: |
Physiological reports - 10(2022), 17 vom: 05. Sept., Seite e15429 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
de Carvalho, Eduardo Butturini [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Acute lung injury |
|---|
| Anmerkungen: |
Date Completed 08.09.2022 Date Revised 17.09.2023 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.14814/phy2.15429 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM345830385 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM345830385 | ||
| 003 | DE-627 | ||
| 005 | 20231226025952.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.14814/phy2.15429 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1152.xml |
| 035 | |a (DE-627)NLM345830385 | ||
| 035 | |a (NLM)36065867 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a de Carvalho, Eduardo Butturini |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Effects of different fluid management on lung and kidney during pressure-controlled and pressure-support ventilation in experimental acute lung injury |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 08.09.2022 | ||
| 500 | |a Date Revised 17.09.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022 The Authors. Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society. | ||
| 520 | |a Optimal fluid management is critical during mechanical ventilation to mitigate lung damage. Under normovolemia and protective ventilation, pulmonary tensile stress during pressure-support ventilation (PSV) results in comparable lung protection to compressive stress during pressure-controlled ventilation (PCV) in experimental acute lung injury (ALI). It is not yet known whether tensile stress can lead to comparable protection to compressive stress in ALI under a liberal fluid strategy (LF). A conservative fluid strategy (CF) was compared with LF during PSV and PCV on lungs and kidneys in an established model of ALI. Twenty-eight male Wistar rats received endotoxin intratracheally. After 24 h, they were treated with CF (minimum volume of Ringer's lactate to maintain normovolemia and mean arterial pressure ≥70 mmHg) or LF (~4 times higher than CF) combined with PSV or PCV (VT = 6 ml/kg, PEEP = 3 cmH2 O) for 1 h. Nonventilated animals (n = 4) were used for molecular biology analyses. CF-PSV compared with LF-PSV: (1) decreased the diffuse alveolar damage score (10 [7.8-12] vs. 25 [23-31.5], p = 0.006), mainly due to edema in axial and alveolar parenchyma; (2) increased birefringence for occludin and claudin-4 in lung tissue and expression of zonula-occludens-1 and metalloproteinase-9 in lung. LF compared with CF reduced neutrophil gelatinase-associated lipocalin and interleukin-6 expression in the kidneys in PSV and PCV. In conclusion, CF compared with LF combined with PSV yielded less lung epithelial cell damage in the current model of ALI. However, LF compared with CF resulted in less kidney injury markers, regardless of the ventilatory strategy | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a acute lung injury | |
| 650 | 4 | |a fluid therapy | |
| 650 | 4 | |a hemodynamics | |
| 650 | 4 | |a immunofluorescence | |
| 650 | 4 | |a immunohistochemistry | |
| 650 | 4 | |a molecular biology | |
| 650 | 4 | |a pressure-support ventilation | |
| 700 | 1 | |a Fonseca, Ana Carolina Fernandes |e verfasserin |4 aut | |
| 700 | 1 | |a Magalhães, Raquel Ferreira |e verfasserin |4 aut | |
| 700 | 1 | |a Pinto, Eliete Ferreira |e verfasserin |4 aut | |
| 700 | 1 | |a Samary, Cynthia Dos Santos |e verfasserin |4 aut | |
| 700 | 1 | |a Antunes, Mariana Alves |e verfasserin |4 aut | |
| 700 | 1 | |a Baldavira, Camila Machado |e verfasserin |4 aut | |
| 700 | 1 | |a da Silveira, Lizandre Keren Ramos |e verfasserin |4 aut | |
| 700 | 1 | |a Teodoro, Walcy Rosolia |e verfasserin |4 aut | |
| 700 | 1 | |a de Abreu, Marcelo Gama |e verfasserin |4 aut | |
| 700 | 1 | |a Capelozzi, Vera Luiza |e verfasserin |4 aut | |
| 700 | 1 | |a Felix, Nathane Santanna |e verfasserin |4 aut | |
| 700 | 1 | |a Pelosi, Paolo |e verfasserin |4 aut | |
| 700 | 1 | |a Rocco, Patrícia Rieken Macêdo |e verfasserin |4 aut | |
| 700 | 1 | |a Silva, Pedro Leme |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Physiological reports |d 2013 |g 10(2022), 17 vom: 05. Sept., Seite e15429 |w (DE-627)NLM228197236 |x 2051-817X |7 nnns |
| 773 | 1 | 8 | |g volume:10 |g year:2022 |g number:17 |g day:05 |g month:09 |g pages:e15429 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.14814/phy2.15429 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 10 |j 2022 |e 17 |b 05 |c 09 |h e15429 | ||