Effects of reduced tidal volume ventilation on pulmonary function in mice before and after acute lung injury
Effects of reduced tidal volume ventilation on pulmonary function in mice before and after acute lung injury
复制标题
DOI：
10.1152/japplphysiol.00006.2007
复制
发表时间：
2007-11-01
影响因子：
3.3
通讯作者：
Suki, Bela
中科院分区：
文献类型：
--
作者：
Thammanomai, Apiradee;Majumdar, Arnab;Suki, Bela
我们研究了负荷阻抗对呼吸机性能的影响，以及潮气量减少对正常小鼠在两种呼气末正压(PEEP)水平下30分钟和10分钟额外通气期间对肺生理学的影响。结果表明，由于小动物呼吸机输送的VT具有负荷依赖性：1)正常小鼠不加控制的呼吸机输送的VT(3-cmH(2)O PEEP时为6ml/kg，6-cmH(2)O PEEP时为7ml/kg)低于规定的VT(8ml/kg)；2)在3-cmH(2)O PEEP时，正常小鼠无控制换气导致肺实质功能异质性增加，SP-B减少，E-钙粘素升高；3)在6-cmH(2)O PEEP时，换气方式对上述参数的影响较小；4)在急性呼吸窘迫综合征灌洗模型中，VT从规定的8ml/kg降至4ml/kg，导致以肺弹性、气道阻力和肺泡组织异质性增加为特征的严重肺功能损害。此外，低VT通气量也导致独立于PEEP的低存活率。这些结果强调了向正常和受伤的肺提供适当的VT的重要性。通过不补偿室速，它可以显著改变小鼠的生理和生物反应。
We investigated the influence of load impedance on ventilator performance and the resulting effects of reduced tidal volume (VT) on lung physiology during a 30-min ventilation of normal mice and 10 min of additional ventilation following lavage-induced injury at two positive end-expiratory pressure (PEEP) levels. Respiratory mechanics were regularly monitored, and the lavage fluid was tested for the soluble E-cadherin, an epithelial cell adhesion molecule, and surfactant protein (SP) B. The results showed that, due to the load dependence of the delivered VT from the small-animal ventilator: 1) uncontrolled ventilation in normal mice resulted in a lower delivered VT (6 ml/ kg at 3-cmH(2)O PEEP and 7 ml/ kg at 6-cmH(2)O PEEP) than the prescribed VT (8 ml/ kg); 2) at 3-cmH(2)O PEEP, uncontrolled ventilation in normal mice led to an increase in lung parenchymal functional heterogeneity, a reduction of SP-B, and an increase in E-cadherin; 3) at 6-cmH(2)O PEEP, ventilation mode had less influence on these parameters; and 4) in a lavage model of acute respiratory distress syndrome, delivered VT decreased to 4 ml/ kg from the prescribed 8 ml/ kg, which resulted in severely compromised lung function characterized by increases in lung elastance, airway resistance, and alveolar tissue heterogeneity. Furthermore, the low VT ventilation also resulted in poor survival rate independent of PEEP. These results highlight the importance of delivering appropriate VT to both the normal and injured lungs. By leaving the VT uncompensated, it can significantly alter physiological and biological responses in mice.