دورية أكاديمية
Comparison between effects of pressure support and pressure-controlled ventilation on lung and diaphragmatic damage in experimental emphysema.
العنوان: | Comparison between effects of pressure support and pressure-controlled ventilation on lung and diaphragmatic damage in experimental emphysema. |
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المؤلفون: | Padilha GA; Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Centro de Ciências da Saúde, Av. Carlos Chagas Filho, s/n, Bloco G-014, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil., Horta LF; Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Centro de Ciências da Saúde, Av. Carlos Chagas Filho, s/n, Bloco G-014, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil., Moraes L; Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Centro de Ciências da Saúde, Av. Carlos Chagas Filho, s/n, Bloco G-014, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil., Braga CL; Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Centro de Ciências da Saúde, Av. Carlos Chagas Filho, s/n, Bloco G-014, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil., Oliveira MV; Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Centro de Ciências da Saúde, Av. Carlos Chagas Filho, s/n, Bloco G-014, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil., Santos CL; Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Centro de Ciências da Saúde, Av. Carlos Chagas Filho, s/n, Bloco G-014, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil., Ramos IP; Laboratory of Molecular and Cellular Cardiology, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.; National Center for Structural Biology and Bio-imaging, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil., Morales MM; Laboratory of Cellular and Molecular Physiology, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil., Capelozzi VL; Department of Pathology, School of Medicine, University of São Paulo, São Paulo, Brazil., Goldenberg RC; Laboratory of Molecular and Cellular Cardiology, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil., de Abreu MG; Pulmonary Engineering Group, Department of Anesthesiology and Intensive Care Therapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany., Pelosi P; Department of Surgical Sciences and Integrated Diagnostics, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy., Silva PL; Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Centro de Ciências da Saúde, Av. Carlos Chagas Filho, s/n, Bloco G-014, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil., Rocco PR; Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Centro de Ciências da Saúde, Av. Carlos Chagas Filho, s/n, Bloco G-014, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil. prmrocco@gmail.com. |
المصدر: | Intensive care medicine experimental [Intensive Care Med Exp] 2016 Dec; Vol. 4 (1), pp. 35. Date of Electronic Publication: 2016 Oct 19. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Springer-Verlag, GmbH Country of Publication: Germany NLM ID: 101645149 Publication Model: Print-Electronic Cited Medium: Print ISSN: 2197-425X (Print) Linking ISSN: 2197425X NLM ISO Abbreviation: Intensive Care Med Exp Subsets: PubMed not MEDLINE |
أسماء مطبوعة: | Original Publication: Heidelberg, Germany : Springer-Verlag, GmbH |
مستخلص: | Background: In patients with emphysema, invasive mechanical ventilation settings should be adjusted to minimize hyperinflation while reducing respiratory effort and providing adequate gas exchange. We evaluated the impact of pressure-controlled ventilation (PCV) and pressure support ventilation (PSV) on pulmonary and diaphragmatic damage, as well as cardiac function, in experimental emphysema. Methods: Emphysema was induced by intratracheal instillation of porcine pancreatic elastase in Wistar rats, once weekly for 4 weeks. Control animals received saline under the same protocol. Eight weeks after first instillation, control and emphysema rats were randomly assigned to PCV (n = 6/each) or PSV (n = 6/each) under protective tidal volume (6 ml/kg) for 4 h. Non-ventilated control and emphysema animals (n = 6/group) were used to characterize the model and for molecular biology analysis. Cardiorespiratory function, lung histology, diaphragm ultrastructure alterations, extracellular matrix organization, diaphragmatic proteolysis, and biological markers associated with pulmonary inflammation, alveolar stretch, and epithelial and endothelial cell damage were assessed. Results: Emphysema animals exhibited cardiorespiratory changes that resemble human emphysema, such as increased areas of lung hyperinflation, pulmonary amphiregulin expression, and diaphragmatic injury. In emphysema animals, PSV compared to PCV yielded: no changes in gas exchange; decreased mean transpulmonary pressure (Pmean,L), ratio between inspiratory and total time (Ti/Ttot), lung hyperinflation, and amphiregulin expression in lung; increased ratio of pulmonary artery acceleration time to pulmonary artery ejection time, suggesting reduced right ventricular afterload; and increased ultrastructural damage to the diaphragm. Amphiregulin correlated with Pmean,L (r = 0.99, p < 0.0001) and hyperinflation (r = 0.70, p = 0.043), whereas Ti/Ttot correlated with hyperinflation (r = 0.81, p = 0.002) and Pmean,L (r = 0.60, p = 0.04). Conclusions: In the model of elastase-induced emphysema used herein, PSV reduced lung damage and improved cardiac function when compared to PCV, but worsened diaphragmatic injury. |
References: | Am J Respir Crit Care Med. 2015 Nov 1;192(9):1080-8. (PMID: 26167730) Physiol Genomics. 2006 Jun 16;26(1):68-75. (PMID: 16569776) Respir Res. 2008 Jan 28;9:13. (PMID: 18226251) Crit Care. 2016 Jan 05;20:1. (PMID: 26728475) Am J Respir Crit Care Med. 2011 Oct 1;184(7):756-62. (PMID: 21700908) Crit Care Med. 2006 Jun;34(6):1738-45. (PMID: 16625116) Eur Respir J. 2010 Mar;35(3):549-56. (PMID: 19717478) Am J Respir Crit Care Med. 2013 Jul 15;188(2):213-9. (PMID: 23641946) PLoS One. 2015 Sep 11;10(9):e0137693. (PMID: 26361212) Semin Respir Crit Care Med. 2014 Aug;35(4):409-17. (PMID: 25105820) Am J Physiol Lung Cell Mol Physiol. 2011 Mar;300(3):L402-13. (PMID: 21224215) Front Physiol. 2016 Jun 30;7:277. (PMID: 27445862) J Am Coll Cardiol. 2014 Nov 11;64(19):2000-9. (PMID: 25440095) Nat Protoc. 2008;3(6):1101-8. (PMID: 18546601) Neth Heart J. 2013 Apr;21(4):166-72. (PMID: 23460128) Proc Natl Acad Sci U S A. 1998 Sep 29;95(20):11869-74. (PMID: 9751757) Anesthesiology. 2015 Aug;123(2):423-33. (PMID: 26039328) Clin Chest Med. 1996 Sep;17(3):379-94. (PMID: 8875002) Crit Care. 2011;15(5):R244. (PMID: 22018091) Curr Opin Pulm Med. 2013 Sep;19(5):437-45. (PMID: 23884296) Cell. 2004 Dec 29;119(7):907-10. (PMID: 15620349) Am J Respir Crit Care Med. 2013 Jul 15;188(2):220-30. (PMID: 23631814) Crit Care. 2010;14 (2):R34. (PMID: 20233399) Chest. 1997 May;111(5):1322-5. (PMID: 9149589) Proc Am Thorac Soc. 2006 Nov;3(8):668-72. (PMID: 17065371) Am J Physiol Lung Cell Mol Physiol. 2011 Jul;301(1):L110-6. (PMID: 21460121) N Engl J Med. 2008 Mar 27;358(13):1327-35. (PMID: 18367735) Crit Care Med. 2012 Apr;40(4):1254-60. (PMID: 22425820) FASEB J. 2004 Jan;18(1):39-51. (PMID: 14718385) Circ Cardiovasc Imaging. 2010 Mar;3(2):157-63. (PMID: 20044514) J Biochem Biophys Methods. 2007 Apr 10;70(3):481-6. (PMID: 17196660) Crit Care. 2014 Aug 12;18(4):474. (PMID: 25113136) Am J Clin Pathol. 2006 Feb;125(2):184-92. (PMID: 16393673) Chest. 2012 Dec;142(6):1545-52. (PMID: 23364913) Acta Cir Bras. 2012 Feb;27(2):109-16. (PMID: 22378364) J Am Soc Echocardiogr. 2015 Jan;28(1):1-39.e14. (PMID: 25559473) Am Rev Respir Dis. 1982 Nov;126(5):788-91. (PMID: 7149443) Crit Care. 2008;12(5):R116. (PMID: 18786263) Front Physiol. 2015 Sep 30;6:267. (PMID: 26483698) PLoS One. 2014 Nov 04;9(11):e111514. (PMID: 25369292) Am J Respir Crit Care Med. 2004 Feb 1;169(3):336-41. (PMID: 14739134) |
فهرسة مساهمة: | Keywords: Amphiregulin; Diaphragm; Echocardiography; Emphysema; Pressure support ventilation |
تواريخ الأحداث: | Date Created: 20161021 Latest Revision: 20200930 |
رمز التحديث: | 20221213 |
مُعرف محوري في PubMed: | PMC5071308 |
DOI: | 10.1186/s40635-016-0107-0 |
PMID: | 27761886 |
قاعدة البيانات: | MEDLINE |
تدمد: | 2197-425X |
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DOI: | 10.1186/s40635-016-0107-0 |