Effects of the Prone Position on Regional Neutrophilic Lung Inflammation According to 18F-FDG Pet in an Experimental Ventilator-Induced Lung Injury Model
Effects of the Prone Position on Regional Neutrophilic Lung Inflammation According to 18F-FDG Pet in an Experimental Ventilator-Induced Lung Injury Model
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根据 18F-FDG Pet 在实验性呼吸机引起的肺损伤模型中俯卧位对局部中性粒细胞性肺部炎症的影响
DOI：
10.1097/shk.0000000000001818
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发表时间：
2022
期刊：
影响因子：
3.1
通讯作者：
Gando Satoshi
中科院分区：
文献类型：
--
作者：
Nakahashi Susumu;Imai Hiroshi;Shimojo Nobutake;Magata Yasuhiro;Einama Takahiro;Hayakawa Mineji;Wada Takeshi;Morimoto Yuji;Gando Satoshi
呼吸机诱导的肺损伤（VILI）可危及生命，因此预防VILI的发生非常重要。目前尚不清楚俯卧位是否影响体内肺部区域的嗜酸性炎症，这在VILI的发病机制中起着至关重要的作用。本研究旨在评估俯卧位的使用与VILI相关的局部嗜酸性肺部炎症的发生之间的关系。在急性实验性损伤的兔肺（由肺灌洗和过度通气引起的肺损伤）中，使用体内2-脱氧-2-[（18）F]氟-D-葡萄糖（18 F-FDG）正电子发射断层扫描和计算机断层扫描评估低潮气量机械通气期间局部嗜酸性肺炎症和肺通气。直接比较三组：控制，仰卧和俯卧位。大约7 h后，仰卧位和俯卧位的组织标准化18 F-FDG摄取存在显著差异（P = 0.038：0.038±0.014 vs. PP：0.029±0.008，P= 0.038），尤其是在腹侧区域（P = 0.052±0.013 vs. PP：0.026±0.007，P= 0.003）。俯卧位的使用减少了肺的不均匀性，这通过校正给定肺区域上的体素气体的不成比例的速率来证明。嗜酸性炎症的进展受到总应变（通气）和不均匀性之间相互作用的影响。俯卧位可有效减缓VILI相关嗜酸性炎症的进展。在低潮气量通气下，其作用的主要驱动力可能是肺组织的均匀化和机械力的均匀化。
Ventilator-induced lung injury (VILI) can be life-threatening and it is important to prevent the development of VILI. It remains unclear whether the prone position affects neutrophilic inflammation in the lung regions in vivo, which plays a crucial role in the pathogenesis of VILI. This study aimed to assess the relationship between the use of the prone position and the development of VILI-associated regional neutrophilic lung inflammation. Regional neutrophilic lung inflammation and lung aeration during low tidal volume mechanical ventilation were assessed using in vivo 2-deoxy-2-[(18) F] fluoro-D-glucose (18 F-FDG) positron emission tomography and computed tomography in acutely experimentally injured rabbit lungs (lung injury induced by lung lavage and excessive ventilation). Direct comparisons were made among three groups: control, supine, and prone positions. After approximately 7 h, tissue-normalized 18 F-FDG uptake differed significantly between the supine and prone positions (SUP: 0.038±0.014 vs. PP: 0.029±0.008, P= 0.038), especially in the ventral region (SUP: 0.052±0.013 vs. PP: 0.026±0.007, P= 0.003). The use of the prone position reduced lung inhomogeneities, which was demonstrated by the correction of the disproportionate rate of voxel gas over the given lung region. The progression of neutrophilic inflammation was affected by the interaction between the total strain (for aeration) and the inhomogeneity. The prone position is effective in slowing down the progression of VILI-associated neutrophilic inflammation. Under low-tidal-volume ventilation, the main drivers of its effect may be homogenization of lung tissue and that of mechanical forces.
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DOI：
10.1164/ajrccm/146.2.300
发表时间：
1992-08-01
期刊：
AMERICAN REVIEW OF RESPIRATORY DISEASE
影响因子：
--
作者：
MUTOH, T;GUEST, RJ;ALBERT, RK
通讯作者：
ALBERT, RK
影响因子：
38.9
作者：
Guérin C;Albert RK;Beitler J;Gattinoni L;Jaber S;Marini JJ;Munshi L;Papazian L;Pesenti A;Vieillard-Baron A;Mancebo J
通讯作者：
Mancebo J
DOI：
10.1164/ajrccm.149.6.7516252
发表时间：
1994-06-01
影响因子：
24.7
作者：
JONES, HA;CLARK, RJ;HASLETT, C
通讯作者：
HASLETT, C
DOI：
10.1164/rccm.200607-915oc
发表时间：
2007-01-15
影响因子：
24.7
作者：
Terragni, Pier Paolo;Rosboch, Giulio;Ranieri, V. Marco
通讯作者：
Ranieri, V. Marco
DOI：
10.1186/s13054-014-0505-1
发表时间：
2014-09-09
期刊：
Critical care (London, England)
影响因子：
--
作者：
Retamal J;Bergamini BC;Carvalho AR;Bozza FA;Borzone G;Borges JB;Larsson A;Hedenstierna G;Bugedo G;Bruhn A
通讯作者：
Bruhn A