Replacement Fibrosis in the Diaphragm of Mechanically Ventilated Critically Ill Patients.
Replacement Fibrosis in the Diaphragm of Mechanically Ventilated Critically Ill Patients.
复制标题
机械通气危重患者隔膜的替代性纤维化。
DOI：
10.1164/rccm.202208-1608le
复制
发表时间：
2023
影响因子：
24.7
通讯作者：
Ottenheijm,CoenAC
中科院分区：
文献类型：
--
作者：
Shi,Zhonghua;vandenBerg,Marloes;Bogaards,Sylvia;Conijn,Stefan;Paul,Marinus;Beishuizen,Albertus;Heunks,Leo;Ottenheijm,CoenAC
方法对54例机械通气危重患者的肋膈活检组织进行冰冻切片，观察膈肌肌纤维大小和ECM面积。对冷冻切片进行快速肌球蛋白重链染色以评估肌纤维类型和横截面积（CSA），并对麦胚凝集素（WGA）进行染色以观察ECM面积（图1A）（7-10）。在12名患者的亚组中，使用已建立的天狼星红染色验证了使用WGA的ECM定量（由于活检尺寸限制）（9）。研究结果与25例接受择期肺手术的对照患者的活检结果进行了比较。排除标准如前所述（8）。该方案由阿姆斯特丹大学医学中心医学伦理委员会批准（方案编号2010/69）。从每例患者和/或法律的代表处获得书面知情同意书。
MethodsTo study the myofiber size and ECM area in the diaphragm, cryosections were cut from costal diaphragm biopsies obtained during surgery of 54 mechanically ventilated critically ill patients. Cryosections were stained for fast myosin heavy chain to assess myofiber type and cross-sectional area (CSA) and wheat germ agglutinin (WGA) to visualize ECM area (Figure 1A)(7–10). ECM quantification using WGA was validated with the established picrosirius red staining in a subset of 12 patients (because of biopsy size limitations)(9). Findings were compared with biopsies from 25 control patients undergoing elective lung surgery. Exclusion criteria were as previously described (8). The protocol was approved by the medical ethics committee of the Amsterdam university medical center (protocol# 2010/69). Written informed consent was obtained from each patient and/or legal representative.