Effect of positive end-expiratory pressure on inflammatory response in oleic acid-induced lung injury and whole-lung lavage-induced lung injury
Effect of positive end-expiratory pressure on inflammatory response in oleic acid-induced lung injury and whole-lung lavage-induced lung injury
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DOI：
10.1007/s00540-006-0465-y
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发表时间：
2007-01-01
影响因子：
2.8
通讯作者：
Makita, Koshi
中科院分区：
文献类型：
--
作者：
Nakazawa, Koichi;Yokoyama, Kuninori;Makita, Koshi
目的。本研究探讨了呼气末正压（PEEP）对两种不同肺损伤模型的炎症反应的影响：油酸（OA）所致的肺水肿；全肺灌洗（LAV）致肺失电性。将28只日本大白兔分为OA组和LAV组，每组均采用间歇正压通气，呼气末压力为零（ZEEP）或呼气末正压（呼气末压力高于下拐点[LIP] 1 cm H2O）。因此，将动物分为LAV-ZEEP、LAV-PEEP、OA-ZEEP和OA-PEEP组。通气治疗3 h后取血及支气管肺泡灌洗液（BALF），分析白细胞介素(IL)-8水平。里约热内卢在诱导肺损伤后显著降低，但在各肺损伤中，PEEP组均显著高于ZEEP组。两种模型血清IL-8水平均升高。LAV-PEEP组血清IL-8水平明显低于LAV-ZEEP组，而OA-PEEP组与OA-ZEEP组血清IL-8水平无显著差异。LAV-PEEP组balfil -8水平低于LAV-ZEEP组。PEEP高于LIP可降低肺不张组BALF和血清中IL-8的升高，但未降低水肿组IL-8的升高。这些结果表明，呼气末正压对损伤肺的保护作用可能取决于潜在的肺病理。
Purpose. The present study investigated the effects of positive end-expiratory pressure (PEEP) on the inflammatory response in two different lung injury models: edematous lung induced by oleic acid (OA); and atelectatic lung induced by whole-lung lavage (LAV).Methods. Japanese white rabbits (n = 28) were allocated to one of the two lung injury (OA or LAV) groups, and each group was treated with intermittent positive pressure ventilation, using zero end-expiratory pressure (ZEEP) or PEEP (1 cm H2O above the lower inflection point [LIP]). Thus, the animals were divided into LAV-ZEEP, LAV-PEEP, OA-ZEEP, and OA-PEEP groups. Blood and bronchoalveolar lavage fluid (BALF) were sampled 3 h after ventilatory treatment to analyze interleukin (IL)-8 levels.Results. Rio, was significantly decreased after the induction of lung injury, but was significantly higher in the PEEP groups compared to the ZEEP groups for each lung injury. Serum IL-8 levels were elevated in both experimental models. Serum IL-8 levels were significantly lower in LAV-PEEP than in LAV-ZEEP, whereas no difference was noted between OA-PEEP and OA-ZEEP. BALF IL-8 levels were lower in LAV-PEEP than in LAV-ZEEP. PEEP above LIP attenuated the elevation of IL-8 in BALF and serum, in atelectatic lungs, but did not attenuate these increases in the edematous lungs.Conclusion. These results suggest that the protective effects of PEEP on injured lungs may depend on the underlying lung pathology.