Impact of Different Tidal Volume Levels at Low Mechanical Power on Ventilator-Induced Lung Injury in Rats. 2018

Lillian Moraes, and Pedro L Silva, and Alessandra Thompson, and Cintia L Santos, and Raquel S Santos, and Marcos V S Fernandes, and Marcelo M Morales, and Vanessa Martins, and Vera L Capelozzi, and Marcelo G de Abreu, and Paolo Pelosi, and Patricia R M Rocco
Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.

Tidal volume (VT) has been considered the main determinant of ventilator-induced lung injury (VILI). Recently, experimental studies have suggested that mechanical power transferred from the ventilator to the lungs is the promoter of VILI. We hypothesized that, as long as mechanical power is kept below a safe threshold, high VT should not be injurious. The present study aimed to investigate the impact of different VT levels and respiratory rates (RR) on lung function, diffuse alveolar damage (DAD), alveolar ultrastructure, and expression of genes related to inflammation [interleukin (IL)-6], alveolar stretch (amphiregulin), epithelial [club cell secretory protein (CC)16] and endothelial [intercellular adhesion molecule (ICAM)-1] cell injury, and extracellular matrix damage [syndecan-1, decorin, and metalloproteinase (MMP)-9] in experimental acute respiratory distress syndrome (ARDS) under low-power mechanical ventilation. Twenty-eight Wistar rats received Escherichia coli lipopolysaccharide intratracheally. After 24 h, 21 animals were randomly assigned to ventilation (2 h) with low mechanical power at three different VT levels (n = 7/group): (1) VT = 6 mL/kg and RR adjusted to normocapnia; (2) VT = 13 mL/kg; and 3) VT = 22 mL/kg. In the second and third groups, RR was adjusted to yield low mechanical power comparable to that of the first group. Mechanical power was calculated as [(Δ[Formula: see text]/Est,L)/2]× RR (ΔP,L = transpulmonary driving pressure, Est,L = static lung elastance). Seven rats were not mechanically ventilated (NV) and were used for molecular biology analysis. Mechanical power was comparable among groups, while VT gradually increased. ΔP,L and mechanical energy were higher in VT = 22 mL/kg than VT = 6 mL/kg and VT = 13 mL/kg (p < 0.001 for both). Accordingly, DAD score increased in VT = 22 mL/kg compared to VT = 6 mL/kg and VT = 13 mL/kg [23(18.5-24.75) vs. 16(12-17.75) and 16(13.25-18), p < 0.05, respectively]. VT = 22 mL/kg was associated with higher IL-6, amphiregulin, CC16, MMP-9, and syndecan-1 mRNA expression and lower decorin expression than VT = 6 mL/kg. Multiple linear regression analyses indicated that VT was able to predict changes in IL-6 and CC16, whereas ΔP,L predicted pHa, oxygenation, amphiregulin, and syndecan-1 expression. In the model of ARDS used herein, even at low mechanical power, high VT resulted in VILI. VT control seems to be more important than RR control to mitigate VILI.

UI MeSH Term Description Entries

Related Publications

Lillian Moraes, and Pedro L Silva, and Alessandra Thompson, and Cintia L Santos, and Raquel S Santos, and Marcos V S Fernandes, and Marcelo M Morales, and Vanessa Martins, and Vera L Capelozzi, and Marcelo G de Abreu, and Paolo Pelosi, and Patricia R M Rocco
October 2005, European journal of anaesthesiology,
Lillian Moraes, and Pedro L Silva, and Alessandra Thompson, and Cintia L Santos, and Raquel S Santos, and Marcos V S Fernandes, and Marcelo M Morales, and Vanessa Martins, and Vera L Capelozzi, and Marcelo G de Abreu, and Paolo Pelosi, and Patricia R M Rocco
November 2016, Anesthesiology,
Lillian Moraes, and Pedro L Silva, and Alessandra Thompson, and Cintia L Santos, and Raquel S Santos, and Marcos V S Fernandes, and Marcelo M Morales, and Vanessa Martins, and Vera L Capelozzi, and Marcelo G de Abreu, and Paolo Pelosi, and Patricia R M Rocco
October 2021, Respiratory care,
Lillian Moraes, and Pedro L Silva, and Alessandra Thompson, and Cintia L Santos, and Raquel S Santos, and Marcos V S Fernandes, and Marcelo M Morales, and Vanessa Martins, and Vera L Capelozzi, and Marcelo G de Abreu, and Paolo Pelosi, and Patricia R M Rocco
July 2019, Intensive care medicine experimental,
Lillian Moraes, and Pedro L Silva, and Alessandra Thompson, and Cintia L Santos, and Raquel S Santos, and Marcos V S Fernandes, and Marcelo M Morales, and Vanessa Martins, and Vera L Capelozzi, and Marcelo G de Abreu, and Paolo Pelosi, and Patricia R M Rocco
January 2022, Experimental lung research,
Lillian Moraes, and Pedro L Silva, and Alessandra Thompson, and Cintia L Santos, and Raquel S Santos, and Marcos V S Fernandes, and Marcelo M Morales, and Vanessa Martins, and Vera L Capelozzi, and Marcelo G de Abreu, and Paolo Pelosi, and Patricia R M Rocco
May 2016, Anesthesiology,
Lillian Moraes, and Pedro L Silva, and Alessandra Thompson, and Cintia L Santos, and Raquel S Santos, and Marcos V S Fernandes, and Marcelo M Morales, and Vanessa Martins, and Vera L Capelozzi, and Marcelo G de Abreu, and Paolo Pelosi, and Patricia R M Rocco
October 2010, Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics,
Lillian Moraes, and Pedro L Silva, and Alessandra Thompson, and Cintia L Santos, and Raquel S Santos, and Marcos V S Fernandes, and Marcelo M Morales, and Vanessa Martins, and Vera L Capelozzi, and Marcelo G de Abreu, and Paolo Pelosi, and Patricia R M Rocco
December 2019, Zhonghua wei zhong bing ji jiu yi xue,
Lillian Moraes, and Pedro L Silva, and Alessandra Thompson, and Cintia L Santos, and Raquel S Santos, and Marcos V S Fernandes, and Marcelo M Morales, and Vanessa Martins, and Vera L Capelozzi, and Marcelo G de Abreu, and Paolo Pelosi, and Patricia R M Rocco
July 2022, Anesthesiology,
Lillian Moraes, and Pedro L Silva, and Alessandra Thompson, and Cintia L Santos, and Raquel S Santos, and Marcos V S Fernandes, and Marcelo M Morales, and Vanessa Martins, and Vera L Capelozzi, and Marcelo G de Abreu, and Paolo Pelosi, and Patricia R M Rocco
July 2016, Acta anaesthesiologica Scandinavica,
Copied contents to your clipboard!