Limits...
Mechanical Ventilation Induces an Inflammatory Response in Preinjured Lungs in Late Phase of Sepsis.

Xuan W, Zhou Q, Yao S, Deng Q, Wang T, Wu Q - Oxid Med Cell Longev (2015)

Bottom Line: Interestingly, in the two groups where rats received low V T MV, we found that infiltration of inflammatory cells was only profound at day 4 after CLP.Marked elevation of protein leakage indicated a compromise in alveolar integrity in rats that received moderate V T MV at day 4 following CLP, correlating with architectural damage to the alveoli.Our study indicates that preinjured lungs are more sensitive to mechanical MV at later phases of sepsis, and this situation may be a result of differing immune status.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.

ABSTRACT
Mechanical ventilation (MV) may amplify the lung-specific inflammatory response in preinjured lungs by elevating cytokine release and augmenting damage to the alveolar integrity. In this study, we test the hypothesis that MV exerts different negative impacts on inflammatory response at different time points of postlung injury. Basic lung injury was induced by cecal ligation and puncture (CLP) surgery in rats. Physiological indexes including blood gases were monitored during MV and samples were assessed following each experiment. Low V T (tidal volume) MV caused a slight increase in cytokine release and tissue damage at day 1 and day 4 after sepsis induced lung injury, while cytokine release from the lungs in the two moderately ventilated V T groups was amplified. Interestingly, in the two groups where rats received low V T MV, we found that infiltration of inflammatory cells was only profound at day 4 after CLP. Marked elevation of protein leakage indicated a compromise in alveolar integrity in rats that received moderate V T MV at day 4 following CLP, correlating with architectural damage to the alveoli. Our study indicates that preinjured lungs are more sensitive to mechanical MV at later phases of sepsis, and this situation may be a result of differing immune status.

No MeSH data available.


Related in: MedlinePlus

Representative hematoxylin and eosin-stained 5 µm lung sections at 400x magnification. CLP at day one without MV (a), with low VT MV (b), and with moderate VT MV (c). CLP at day four without MV (d), with low VT MV (e), and with moderate VT MV (f) are shown. Lung injuries according to the scoring system are pointed with black arrow in the figures. Lung injury score is presented as bar chart on the right (g). Data are presented as mean ± SD.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4487711&req=5

fig2: Representative hematoxylin and eosin-stained 5 µm lung sections at 400x magnification. CLP at day one without MV (a), with low VT MV (b), and with moderate VT MV (c). CLP at day four without MV (d), with low VT MV (e), and with moderate VT MV (f) are shown. Lung injuries according to the scoring system are pointed with black arrow in the figures. Lung injury score is presented as bar chart on the right (g). Data are presented as mean ± SD.

Mentions: CLP surgery caused moderate structural damage of lung, slight cellular infiltration, and edema at days one and four after operation (Figures 2(a) and 2(d)). We saw more severe accumulation of inflammatory cells in groups CLP1day + LMV and CLP4day + LMV (Figures 2(b) and 2(e)). For moderate VT MV one day after sepsis, these histological changes were similar to those in two low VT groups (Figure 2(c)). The impacts of MV were most evident in group CLP4day + MMV, with partial interstitial edema and areas of alveolar hemorrhage (Figure 2(f)), which showed that relatively higher tidal volume MV exerted more negative impact on preinjured lung at day four after CLP compared with day one following CLP.


Mechanical Ventilation Induces an Inflammatory Response in Preinjured Lungs in Late Phase of Sepsis.

Xuan W, Zhou Q, Yao S, Deng Q, Wang T, Wu Q - Oxid Med Cell Longev (2015)

Representative hematoxylin and eosin-stained 5 µm lung sections at 400x magnification. CLP at day one without MV (a), with low VT MV (b), and with moderate VT MV (c). CLP at day four without MV (d), with low VT MV (e), and with moderate VT MV (f) are shown. Lung injuries according to the scoring system are pointed with black arrow in the figures. Lung injury score is presented as bar chart on the right (g). Data are presented as mean ± SD.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4487711&req=5

fig2: Representative hematoxylin and eosin-stained 5 µm lung sections at 400x magnification. CLP at day one without MV (a), with low VT MV (b), and with moderate VT MV (c). CLP at day four without MV (d), with low VT MV (e), and with moderate VT MV (f) are shown. Lung injuries according to the scoring system are pointed with black arrow in the figures. Lung injury score is presented as bar chart on the right (g). Data are presented as mean ± SD.
Mentions: CLP surgery caused moderate structural damage of lung, slight cellular infiltration, and edema at days one and four after operation (Figures 2(a) and 2(d)). We saw more severe accumulation of inflammatory cells in groups CLP1day + LMV and CLP4day + LMV (Figures 2(b) and 2(e)). For moderate VT MV one day after sepsis, these histological changes were similar to those in two low VT groups (Figure 2(c)). The impacts of MV were most evident in group CLP4day + MMV, with partial interstitial edema and areas of alveolar hemorrhage (Figure 2(f)), which showed that relatively higher tidal volume MV exerted more negative impact on preinjured lung at day four after CLP compared with day one following CLP.

Bottom Line: Interestingly, in the two groups where rats received low V T MV, we found that infiltration of inflammatory cells was only profound at day 4 after CLP.Marked elevation of protein leakage indicated a compromise in alveolar integrity in rats that received moderate V T MV at day 4 following CLP, correlating with architectural damage to the alveoli.Our study indicates that preinjured lungs are more sensitive to mechanical MV at later phases of sepsis, and this situation may be a result of differing immune status.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.

ABSTRACT
Mechanical ventilation (MV) may amplify the lung-specific inflammatory response in preinjured lungs by elevating cytokine release and augmenting damage to the alveolar integrity. In this study, we test the hypothesis that MV exerts different negative impacts on inflammatory response at different time points of postlung injury. Basic lung injury was induced by cecal ligation and puncture (CLP) surgery in rats. Physiological indexes including blood gases were monitored during MV and samples were assessed following each experiment. Low V T (tidal volume) MV caused a slight increase in cytokine release and tissue damage at day 1 and day 4 after sepsis induced lung injury, while cytokine release from the lungs in the two moderately ventilated V T groups was amplified. Interestingly, in the two groups where rats received low V T MV, we found that infiltration of inflammatory cells was only profound at day 4 after CLP. Marked elevation of protein leakage indicated a compromise in alveolar integrity in rats that received moderate V T MV at day 4 following CLP, correlating with architectural damage to the alveoli. Our study indicates that preinjured lungs are more sensitive to mechanical MV at later phases of sepsis, and this situation may be a result of differing immune status.

No MeSH data available.


Related in: MedlinePlus