scholarly journals Airway Humidification Reduces the Inflammatory Response During Mechanical Ventilation

2015 ◽  
Vol 60 (12) ◽  
pp. 1720-1728 ◽  
Author(s):  
M. Jiang ◽  
J.-J. Song ◽  
X.-L. Guo ◽  
Y.-L. Tang ◽  
H.-B. Li
Keyword(s):  
Mechanical Ventilation ◽  
Inflammatory Response ◽  
Airway Humidification

scholarly journals Effects of Various Modes of Mechanical Ventilation in Normal Rats

2014 ◽  
Vol 120 (4) ◽  
pp. 943-950 ◽  
Author(s):  
Matteo Pecchiari ◽  
Ario Monaco ◽  
Antonia Koutsoukou ◽  
Patrizia Della Valle ◽  
Guendalina Gentile ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Lung Injury ◽  
Inflammatory Response ◽  
Negative Pressure ◽  
Positive Pressure Ventilation ◽  
Lung Mechanics ◽  
Whole Body ◽  
Positive Pressure ◽  
Negative Pressure Ventilation ◽  
Cytokine Levels

Abstract Background: Recent studies in healthy mice and rats have reported that positive pressure ventilation delivered with physiological tidal volumes at normal end-expiratory volume worsens lung mechanics and induces cytokine release, thus suggesting that detrimental effects are due to positive pressure ventilation per se. The aim of this study in healthy animals is to assess whether these adverse outcomes depend on the mode of mechanical ventilation. Methods: Rats were subjected to 4 h of spontaneous, positive pressure, and whole-body or thorax-only negative pressure ventilation (N = 8 per group). In all instances the ventilatory pattern was that of spontaneous breathing. Lung mechanics, cytokines concentration in serum and broncho–alveolar lavage fluid, lung wet-to-dry ratio, and histology were assessed. Values from eight animals euthanized shortly after anesthesia served as control. Results: No evidence of mechanical ventilation–dependent lung injury was found in terms of lung mechanics, histology, or wet-to-dry ratio. Relative to control, cytokine levels and recruitment of polymorphonuclear leucocytes increased slightly, and to the same extent with spontaneous, positive pressure, and whole-body negative pressure ventilation. Thorax-only negative pressure ventilation caused marked chest and lung distortion, reversible increase of lung elastance, and higher polymorphonuclear leucocyte count and cytokine levels. Conclusion: Both positive and negative pressure ventilation performed with tidal volumes and timing of spontaneous, quiet breathing neither elicit an inflammatory response nor cause morpho-functional alterations in normal animals, thus supporting the notion of the presence of a critical volume threshold above which acute lung injury ensues. Distortion of lung parenchyma can induce an inflammatory response, even in the absence of volotrauma.

scholarly journals Postoperative Pulmonary Dysfunction and Mechanical Ventilation in Cardiac Surgery

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Rafael Badenes ◽  
Angels Lozano ◽  
F. Javier Belda
Keyword(s):  
Mechanical Ventilation ◽  
Cardiac Surgery ◽  
Inflammatory Response ◽  
Pulmonary Inflammation ◽  
Protective Ventilation ◽  
Pulmonary Dysfunction ◽  
Gas Exchange Parameters ◽  
Ventilatory Strategy ◽  
Protective Ventilation Strategy ◽  
Postoperative Pulmonary Dysfunction

Postoperative pulmonary dysfunction (PPD) is a frequent and significant complication after cardiac surgery. It contributes to morbidity and mortality and increases hospitalization stay and its associated costs. Its pathogenesis is not clear but it seems to be related to the development of a systemic inflammatory response with a subsequent pulmonary inflammation. Many factors have been described to contribute to this inflammatory response, including surgical procedure with sternotomy incision, effects of general anesthesia, topical cooling, and extracorporeal circulation (ECC) and mechanical ventilation (VM). Protective ventilation strategies can reduce the incidence of atelectasis (which still remains one of the principal causes of PDD) and pulmonary infections in surgical patients. In this way, the open lung approach (OLA), a protective ventilation strategy, has demonstrated attenuating the inflammatory response and improving gas exchange parameters and postoperative pulmonary functions with a better residual functional capacity (FRC) when compared with a conventional ventilatory strategy. Additionally, maintaining low frequency ventilation during ECC was shown to decrease the incidence of PDD after cardiac surgery, preserving lung function.

Mechanical ventilation is the determining factor in inducing an inflammatory response in a hemorrhagic shock model

2013 ◽  
Vol 180 (1) ◽  
pp. 125-132 ◽  
Author(s):  
Karlijn J.P. van Wessem ◽  
Marije P. Hennus ◽  
Marjolein Heeres ◽  
Leo Koenderman ◽  
Luke P.H. Leenen
Keyword(s):  
Mechanical Ventilation ◽  
Inflammatory Response ◽  
Hemorrhagic Shock ◽  
Shock Model ◽  
Determining Factor ◽  
Hemorrhagic Shock Model

Mild hypothermia increases pulmonary anti-inflammatory response during protective mechanical ventilation in a piglet model of acute lung injury

2013 ◽  
Vol 23 (11) ◽  
pp. 1069-1077 ◽  
Author(s):  
Pablo Cruces ◽  
Benjamín Erranz ◽  
Alejandro Donoso ◽  
Cristóbal Carvajal ◽  
Tatiana Salomón ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Acute Lung Injury ◽  
Lung Injury ◽  
Inflammatory Response ◽  
Mild Hypothermia ◽  
Anti Inflammatory ◽  
Protective Mechanical Ventilation

Mechanical ventilation increases the inflammatory response induced by lung contusion

2013 ◽  
Vol 183 (1) ◽  
pp. 377-384 ◽  
Author(s):  
Karlijn J.P. van Wessem ◽  
Marije P. Hennus ◽  
Linda van Wagenberg ◽  
Leo Koenderman ◽  
Luke P.H. Leenen
Keyword(s):  
Mechanical Ventilation ◽  
Inflammatory Response ◽  
Lung Contusion

Increased Susceptibility to Ventilator-associated Lung Injury Persists after Clinical Recovery from Experimental Endotoxemia

2006 ◽  
Vol 104 (1) ◽  
pp. 133-141 ◽  
Author(s):  
Torsten Schreiber ◽  
Lars Hueter ◽  
Konrad Schwarzkopf ◽  
Sylvia Hohlstein ◽  
Barbara Schmidt ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Lung Injury ◽  
Inflammatory Response ◽  
Weight Ratio ◽  
Dry Weight ◽  
Lavage Fluid ◽  
Systemic Injection ◽  
Endotoxin Challenge ◽  
Clinical Recovery ◽  
Increased Susceptibility

Background Endotoxin, when delivered shortly before or during mechanical ventilation, increases susceptibility to ventilation-associated lung injury. However, it is unclear whether increased susceptibility to ventilator-associated lung injury is still present after clinical recovery from a transient endotoxin challenge. Methods Anesthetized rats were submitted to a 4-h period of mechanical ventilation with low (8 ml/kg) or high (24, 27, or 30 ml/kg) tidal volumes (VTs) 24 h after transient illness had been provoked by a single nonlethal intravenous injection of Escherichia coli endotoxin. Control animals were injected with phosphate-buffered saline and underwent the same protocol. Results At 24 h, endotoxin-treated nonventilated animals showed no symptoms of clinical illness, and oxygenation was comparable with that of controls, but lung neutrophil counts were increased. Compared with controls, mechanical ventilation with high VT induced a stronger pulmonary inflammatory response and more severe lung injury in endotoxin-treated animals, as indicated by impaired oxygenation, increased lung wet-to-dry weight ratio, and increased levels of protein, neutrophils, and cytokines in lung lavage fluid. In addition, the highest VT resulted in increased mortality in endotoxin-treated animals. Low VT after endotoxin treatment did not cause functional pulmonary impairment but induced an inflammatory response. Conclusions In this animal model, a 24-h delay after a single systemic injection of endotoxin resulted in clinical recovery and preserved pulmonary function but did not prevent increased susceptibility to ventilator-associated lung injury provoked by high VT. Residual pulmonary inflammation and neutrophilic infiltration at initiation of mechanical ventilation probably contribute to these findings.

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