Repeated open endotracheal suctioning causes gradual desaturation but does not exacerbate lung injury compared to closed endotracheal suctioning in a rabbit model of ARDS.
Repeated open endotracheal suctioning causes gradual desaturation but does not exacerbate lung injury compared to closed endotracheal suctioning in a rabbit model of ARDS.
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DOI：
10.1186/1471-2253-13-47
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发表时间：
2013-12-05
影响因子：
2.2
通讯作者：
Mizutani T
中科院分区：
文献类型：
--
作者：
Sakuramoto H;Shimojo N;Jesmin S;Unoki T;Kamiyama J;Oki M;Miya K;Kawano S;Mizutani T
虽然在机械通气过程中气管内吸痰会引起肺泡萎缩，但反复气管内吸痰是否会加重肺损伤尚不清楚。本研究旨在确定在急性呼吸窘迫综合征（ARDS）动物模型中，与闭合性气管内吸引（CS）相比，机械通气期间反复开放气管内吸引（OS）是否会加重肺损伤。简单地说，36只日本大白兔最初以恒定潮气量（6 mL/kg）的压力控制模式通气。然后经反复生理盐水灌洗诱导肺损伤。将家兔分为4组，即：a) OS组；b)计算机科学;c)仅用ARDS进行控制；d)无ARDS的健康对照（HC）。各组动物均以10 cm H2O呼气末正压通气。采用6根法式闭式吸引管连接气管内管，在以下条件下进行CS: a)吸引时间为10秒，压力为140 mm Hg；b)吸入深度2厘米（转接器长度）加气管管。除呼吸机与动物断开连接外，OS采用与CS相同的条件进行。每次气管内吸痰间隔30min。CS组、对照组和HC组PaO2/FIO2 （P/F）随每次吸痰持续6h保持在bb0 400，而OS组PaO2/FIO2 （P/F）随每次吸痰逐渐下降至300 （P < 0.05）。然而，在肺损伤评分（组织学）和炎症因子（肿瘤坏死因子-α和白细胞介素-6）的表达模式6小时后，OS组和CS组在循环组织和肺组织中均无差异。反复气管内吸引条件下，OS患者的进行性动脉去饱和程度大于CS患者，这与时间有关。然而，基于形态学和分子分析，在更长的时间跨度（6小时）反复气管内吸痰观察时，OS不会加剧机械通气期间的肺损伤。
Although endotracheal suctioning induces alveolar derecruitment during mechanical ventilation, it is not clear whether repeated endotracheal suctioning exacerbates lung injuries. The present study aimed to determine whether repeated open endotracheal suctioning (OS) exacerbates lung injury compared to closed endotracheal suctioning (CS) during mechanical ventilation in an animal model of acute respiratory distress syndrome (ARDS). Briefly, thirty six Japanese white rabbits were initially ventilated in pressure-controlled mode with a constant tidal volume (6 mL/kg). Then, lung injury was induced by repeated saline lavage. The rabbits were divided into four groups, namely: a) OS; b) CS; c) control with ARDS only; d) and healthy control (HC) without ARDS. Animals in all the groups were then ventilated with positive end expiratory pressure (PEEP) at 10 cm H2O. CS was performed using 6 French-closed suctioning catheters connected to endotracheal tube under the following conditions: a) a suctioning time and pressure of 10 sec and 140 mm Hg, respectively; and b) a suction depth of 2 cm (length of adapter) plus tracheal tube. OS was performed using the same conditions described for CS, except the ventilator was disconnected from the animals. Each endotracheal suctioning was performed at an interval of 30 min. PaO2/FIO2 (P/F) ratio for CS, control and HC groups remained at >400 for 6 hours, whereas that of the OS group progressively declined to 300 (p < 0.05), with each suctioning. However, no difference was observed either in lung injury score (histology) or in the expression pattern of inflammatory cytokines (tumor necrosis factor-α and interleukin-6) after 6 hours between the OS and CS groups in the circulatory as well as the pulmonary tissues. Progressive arterial desaturation under conditions of repeated endotracheal suctioning is greater in OS than in CS time-dependently. However, OS does not exacerbate lung injury during mechanical ventilation when observed over a longer time span (6 hours) of repeated endotracheal suctioning, based on morphological and molecular analysis.
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影响因子：
2.1
作者：
LACHMANN, B;ROBERTSON, B;VOGEL, J
通讯作者：
VOGEL, J
DOI：
10.1164/rccm.200112-117oc
发表时间：
2002-08-01
影响因子：
24.7
作者：
Sinclair, SE;Kregenow, DA;Hlastala, MP
通讯作者：
Hlastala, MP
DOI：
10.1186/cc1844
发表时间：
2003-02
期刊：
Critical care (London, England)
影响因子：
--
作者：
Dyhr T;Bonde J;Larsson A
通讯作者：
Larsson A
影响因子：
38.9
作者：
Cereda, M;Villa, F;Pesenti, A
通讯作者：
Pesenti, A
影响因子：
8.8
作者：
Koh, WJ;Suh, GY;Kwon, OJ
通讯作者：
Kwon, OJ