Mechanical ventilation of isolated septic rat lungs: effects on surfactant and inflammatory cytokines
Mechanical ventilation of isolated septic rat lungs: effects on surfactant and inflammatory cytokines
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DOI：
10.1152/jappl.2001.91.2.811
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发表时间：
2001-08-01
影响因子：
3.3
通讯作者：
Veldhuizen, R
中科院分区：
文献类型：
--
作者：
Nakamura, T;Malloy, J;Veldhuizen, R
研究了机械通气对脓毒症大鼠离体肺表面活性物质系统及细胞因子分泌的影响。在假手术或盲肠结扎穿孔（CLP）诱导脓毒症后23 h，切除肺并随机分为三组：1)非通气组，2)非损伤性MV 1 h组（潮气量= 10 ml/kg，呼气末正压= 3 cmH(2)O），或3)损伤性MV 1 h组（潮气量= 20 ml/kg，呼气末正压= 0 cmH2O）。不通气的假肺和CLP肺具有相似的顺应性，肺形态、表面活性物质和细胞因子浓度正常。与不通气相比，假肺和CLP肺损伤性通气降低顺应性，改变表面活性物质，增加细胞因子，并诱导形态学改变。假性肺和CLP肺的表面活性物质系统相似；然而，肿瘤坏死因子- α和白细胞介素-6水平在CLP肺中显著升高。我们的结论是，损伤性通气改变了表面活性物质，与败血症无关，CLP肺因通气而倾向于分泌大量细胞因子。
The effects of mechanical ventilation (MV) on the surfactant system and cytokine secretion were studied in isolated septic rat lungs. At 23 h after sham surgery or induction of sepsis by cecal ligation and perforation (CLP), lungs were excised and randomized to one of three groups: 1) a nonventilated group, 2) a group subjected to 1 h of noninjurious MV (tidal volume = 10 ml/kg, positive end-expiratory pressure = 3 cmH(2)O), or 3) a group subjected to 1 h of injurious MV (tidal volume = 20 ml/kg, positive end-expiratory pressure = 0 cmH2O). Nonventilated sham and CLP lungs had similar compliance, normal lung morphology, surfactant, and cytokine concentrations. Injurious ventilation decreased compliance, altered surfactant, increased cytokines, and induced morphological changes compared with nonventilation in sham and CLP lungs. In these lungs, the surfactant system was similar in sham and CLP lungs; however, tumor necrosis factor-alpha and interleukin-6 levels were significantly higher in CLP lungs. We conclude that injurious ventilation altered surfactant independent of sepsis and that the CLP lungs were predisposed to the secretion of larger amounts of cytokines because of ventilation.