Dynamic alveolar mechanics in four models of lung injury
Dynamic alveolar mechanics in four models of lung injury
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DOI：
10.1007/s00134-005-2854-3
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发表时间：
2006-01-01
影响因子：
38.9
通讯作者：
Nieman, GF
中科院分区：
文献类型：
--
作者：
DiRocco, JD;Pavone, LA;Nieman, GF
目的：确定肺泡力学的病理改变（即，肺泡大小和形状随通气的动态变化）在相似的肺损伤水平下根据损伤原因而变化。设计和设置：在大学实验室进行的前瞻性对照动物研究。对象：30只雄性Sprague-Dawley大鼠（300-550 g）。干预措施：将大鼠分为四种肺损伤模型之一或对照（n=6）：（a）2%吐温-20（Tween，n=6），（B）油酸（OA，n=6），（c）呼吸机诱导的肺损伤（VILI，PIP 40/ZEEP，n=6），（d）内毒素（LPS，n=6）。在基线和损伤后（PaO 2/FIO 2 < 300 mmHg）通过体内显微镜评估肺泡力学。测量：肺泡不稳定性（通气期间肺泡大小的比例变化）被用作肺泡力学的测量。结果如下：随着低氧血症的发展，肺泡在吐温、OA和VILI中不稳定（基线与损伤：吐温，7 +/- 2%与67 +/- 5%; OA：3 +/- 2%与82 +/- 9%; VILI，4 +/- 2%与72 +/- 5%）。LPS后的低氧血症与显著的肺泡不稳定性无关（基线vs.损伤：LPS，3 +/- 2 vs. 8 +/- 5%）。结论：这些数据表明，在动态肺泡力学中存在多种病理变化。这些变化的性质取决于肺损伤的机制。
Objective: To determine whether pathological alterations in alveolar mechanics (i.e., the dynamic change in alveolar size and shape with ventilation) at a similar level of lung injury vary depending on the cause of injury. Design and setting: Prospective controlled animal study in a university laboratory. Subjects: 30 male Sprague-Dawley rats (300-550 g). Interventions: Rats were separated into one of four lung injury models or control (n=6): (a) 2% Tween-20 (Tween, n=6), (b) oleic acid (OA, n=6), (c) ventilator-induced lung injury (VILI, PIP 40/ZEEP, n=6), (d) endotoxin (LPS, n=6). Alveolar mechanics were assessed at baseline and after injury (PaO2/FIO2 < 300 mmHg) by in vivo microscopy. Measurements: Alveolar instability (proportional change in alveolar size during ventilation) was used as a measurement of alveolar mechanics. Results: Alveoli were unstable in Tween, OA, and VILI as hypoxemia developed ( baseline vs. injury: Tween, 7 +/- 2% vs. 67 +/- 5%; OA: 3 +/- 2% vs. 82 +/- 9%; VILI, 4 +/- 2% vs. 72 +/- 5%). Hypoxemia after LPS was not associated with significant alveolar instability ( baseline vs. injury: LPS, 3 +/- 2 vs. 8 +/- 5%). Conclusions: These data demonstrate that multiple pathological changes occur in dynamic alveolar mechanics. The nature of these changes depends upon the mechanism of lung injury.