Mechanical ventilation and lung infection in the genesis of air-space enlargement.
Mechanical ventilation and lung infection in the genesis of air-space enlargement.
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DOI：
10.1186/cc5680
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Rouby JJ
中科院分区：
文献类型：
--
作者：
Sartorius A;Lu Q;Vieira S;Tonnellier M;Lenaour G;Goldstein I;Rouby JJ
机械通气和/或肺部感染可能导致空气空间扩大。本研究的目的是评估机械通气和肺部感染如何影响细支气管和肺泡扩张的发生。研究了四组仔猪：非通风-非接种（对照，n = 5）、非通风-接种（n = 6）、通风-非接种（n = 6）和通风-接种（n = 8）仔猪。用高浓度的大肠杆菌溶液接种插管仔猪的呼吸道。在60小时内维持机械通气，潮气量为15 ml/kg，呼气末正压为零。放血处死后，固定肺进行组织学和肺形态测定分析。肺部感染存在于所有接种仔猪和5/6只通气未接种仔猪中。平均肺泡和平均细支气管面积，使用通过高分辨率彩色摄像机连接到光学显微镜的分析计算机系统测量，在非通气接种动物中显著增加（与对照组相比，分别为+16%和+11%），在通气-未接种动物中（与对照组相比，分别为+49%和+49%）和通气接种动物（与对照组相比，分别为+95%和+118%）。平均肺泡和平均细支气管面积与肺部感染的范围显著相关（分别为R = 0.50，p < 0.01和R = 0.67，p < 0.001）。肺部感染引起细支气管和肺泡扩张。机械通气可引起继发性肺部感染，并与进一步的空气空间扩大有关。原发性肺部感染和机械通气的结合明显增加了空气空间的扩大，其程度取决于肺部感染的严重程度和范围。
Air-space enlargement may result from mechanical ventilation and/or lung infection. The aim of this study was to assess how mechanical ventilation and lung infection influence the genesis of bronchiolar and alveolar distention. Four groups of piglets were studied: non-ventilated-non-inoculated (controls, n = 5), non-ventilated-inoculated (n = 6), ventilated-non-inoculated (n = 6), and ventilated-inoculated (n = 8) piglets. The respiratory tract of intubated piglets was inoculated with a highly concentrated solution of Escherichia coli. Mechanical ventilation was maintained during 60 hours with a tidal volume of 15 ml/kg and zero positive end-expiratory pressure. After sacrifice by exsanguination, lungs were fixed for histological and lung morphometry analyses. Lung infection was present in all inoculated piglets and in five of the six ventilated-non-inoculated piglets. Mean alveolar and mean bronchiolar areas, measured using an analyzer computer system connected through a high-resolution color camera to an optical microscope, were significantly increased in non-ventilated-inoculated animals (+16% and +11%, respectively, compared to controls), in ventilated-non-inoculated animals (+49% and +49%, respectively, compared to controls), and in ventilated-inoculated animals (+95% and +118%, respectively, compared to controls). Mean alveolar and mean bronchiolar areas significantly correlated with the extension of lung infection (R = 0.50, p < 0.01 and R = 0.67, p < 0.001, respectively). Lung infection induces bronchiolar and alveolar distention. Mechanical ventilation induces secondary lung infection and is associated with further air-space enlargement. The combination of primary lung infection and mechanical ventilation markedly increases air-space enlargement, the degree of which depends on the severity and extension of lung infection.
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DOI：
10.1164/ajrccm.160.1.9809006
发表时间：
1999-07-01
影响因子：
24.7
作者：
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