Mechanical ventilation interacts with endotoxemia to induce extrapulmonary organ dysfunction.
Mechanical ventilation interacts with endotoxemia to induce extrapulmonary organ dysfunction.
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DOI：
10.1186/cc5050
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发表时间：
2006
期刊：
影响因子：
--
通讯作者：
Matute-Bello G
中科院分区：
文献类型：
--
作者：
O'Mahony DS;Liles WC;Altemeier WA;Dhanireddy S;Frevert CW;Liggitt D;Martin TR;Matute-Bello G
多器官功能障碍综合征（Multiple organs dysfunction syndrome，MODS）是急性呼吸窘迫综合征（acute respiratory distress syndrome，ARDS）机械通气患者脓毒症的常见并发症，但机械通气与MODS的关系尚不清楚。我们的目标是确定是否有一个最低限度的伤害机械通气策略协同低剂量内毒素血症，诱导激活促炎症途径在肺和体循环，导致远端器官功能障碍和/或损伤。我们将大肠杆菌脂多糖（LPS; 1 μg/g）腹腔内给予C57 BL/6小鼠，14小时后使小鼠经受6小时的机械通气，潮气量为10 ml/kg（LPS + MV）。对照组接受通气但无LPS（MV）、LPS但无通气（LPS）、或LPS和通气（磷酸盐缓冲盐水; PBS）均无。与PBS组相比，LPS + MV组小鼠肺中髓过氧化物酶活性和趋化因子巨噬细胞炎性蛋白-2（MIP-2）和KC的浓度显著增加。有趣的是，在LPS + MV组小鼠中，肺泡上皮的通透性变化和提示肺损伤的组织学变化最小。然而，尽管肺损伤最小，但机械通气和LPS的组合导致肝和肾损伤的化学和组织学证据，这与KC、MIP-2、IL-6和TNF-α的血浆浓度增加相关。非损伤性机械通气策略与小鼠内毒素血症相互作用，以增强肺部的促炎机制并促进肺外终末器官损伤，即使在没有明显急性肺损伤的情况下。
Multiple organ dysfunction syndrome (MODS) is a common complication of sepsis in mechanically ventilated patients with acute respiratory distress syndrome, but the links between mechanical ventilation and MODS are unclear. Our goal was to determine whether a minimally injurious mechanical ventilation strategy synergizes with low-dose endotoxemia to induce the activation of pro-inflammatory pathways in the lungs and in the systemic circulation, resulting in distal organ dysfunction and/or injury. We administered intraperitoneal Escherichia coli lipopolysaccharide (LPS; 1 μg/g) to C57BL/6 mice, and 14 hours later subjected the mice to 6 hours of mechanical ventilation with tidal volumes of 10 ml/kg (LPS + MV). Comparison groups received ventilation but no LPS (MV), LPS but no ventilation (LPS), or neither LPS nor ventilation (phosphate-buffered saline; PBS). Myeloperoxidase activity and the concentrations of the chemokines macrophage inflammatory protein-2 (MIP-2) and KC were significantly increased in the lungs of mice in the LPS + MV group, in comparison with mice in the PBS group. Interestingly, permeability changes across the alveolar epithelium and histological changes suggestive of lung injury were minimal in mice in the LPS + MV group. However, despite the minimal lung injury, the combination of mechanical ventilation and LPS resulted in chemical and histological evidence of liver and kidney injury, and this was associated with increases in the plasma concentrations of KC, MIP-2, IL-6, and TNF-α. Non-injurious mechanical ventilation strategies interact with endotoxemia in mice to enhance pro-inflammatory mechanisms in the lungs and promote extra-pulmonary end-organ injury, even in the absence of demonstrable acute lung injury.
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影响因子：
3.8
作者：
Jaeschke, H;Gores, GJ;Lemasters, JJ
通讯作者：
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影响因子：
6.4
作者：
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通讯作者：
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影响因子：
6.4
作者：
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影响因子：
9.6
作者：
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影响因子：
120.7
作者：
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