Comparison of acid-induced inflammatory responses in the rat lung during high frequency oscillatory and conventional mechanical ventilation

Jian, Ming; Koizumi, Tomonobu; Yokoyama, Toshiki; Tsushima, Kenji; Kubo, Keishi

doi:10.1007/s00011-010-0204-6

Cited by 4 publications

(3 citation statements)

References 26 publications

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“…11,15,24,35 In accordance with previous reports, our study confirmed that HFOV improved oxygenation, and reduced inflammatory and histopathological injuries. 11,15,35–37 Recently, Jian et al 38 showed reduced inflammatory responses measured by tumor necrosis factor-alpha (TNF- α ) production and neutrophil infiltration in bronchoalveolar lavage fluid in a rat model of ALI. Our ALI groups exhibited significant hypoxemia after lung lavage and prompt recovery by HFOV.…”

Section: Discussionmentioning

confidence: 99%

High-frequency oscillatory ventilation attenuates oxidative lung injury in a rabbit model of acute lung injury

Ronchi

Ferreira²,

Campos³

et al. 2011

Exp Biol Med (Maywood)

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Mechanical ventilation (MV) can induce lung oxidative stress, which plays an important role in pulmonary injury. This study compared protective conventional mechanical ventilation (CMV) and high-frequency oscillatory ventilation (HFOV) for oxygenation, oxidative stress, inflammatory and histopathological lung injury in a rabbit model of acute lung injury (ALI). Rabbits (n = 30) were ventilated at FiO(2) 1.0. Lung injury was induced by tracheal saline infusion (30 mL/kg, 38°C). Animals were randomly assigned to: (a) sham control (CG: tidal volume [V(T)] 6 mL/kg, positive end expiratory pressure [PEEP] 5 cmH(2)O, respiratory rate [RR] 40 ipm); (b) ALI + CMV (CMVG: V(T) 6 mL/kg, PEEP 10 cmH(2)O, RR 40 ipm); or (c) ALI + HFOV (HFG: mean airway pressure [Paw] 14 cmH(2)O, RR 10 Hz) groups. Lung oxidative stress was assessed by total antioxidant performance assay, inflammatory response by the number of polymorphonuclear leukocytes/bronchoalveolar lavage fluid/lung and pulmonary histological damage was quantified by a score. Ventilatory and hemodynamic parameters were recorded every 30 min. Both ALI groups showed worse oxygenation after lung injury induction. After four hours of ventilation, HFG showed better oxygenation (partial pressure of oxygen [PaO(2)] - CG: 465.9 ± 30.5 = HFG: 399.1 ± 98.2 > CMVG: 232.7 ± 104 mmHg, P < 0.05) and inflammatory responses (CMVG: 4.27 ± 1.50 > HFG: 0.33 ± 0.20 = CG: 0.16 ± 0.15; polymorphonuclear cells/bronchoalveolar lavage fluid/lung, P < 0.05), less histopathological injury score (CMVG: 5 [1-16] > HFG: 1 [0-5] > CG: 0 [0-3]; P < 0.05), and lower lung oxidative stress than CMVG (CG: 59.4 ± 4.52 = HFG: 69.0 ± 4.99 > CMVG: 47.6 ± 2.58% protection/g protein, P < 0.05). This study showed that HFOV had an important protective role in ALI. It improved oxygenation, reduced inflammatory process and histopathological damage, and attenuated oxidative lung injury compared with protective CMV under these experimental conditions considering the study limitations.

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Section: Discussionmentioning

confidence: 99%

High-frequency oscillatory ventilation attenuates oxidative lung injury in a rabbit model of acute lung injury

Ronchi

Ferreira²,

Campos³

et al. 2011

Exp Biol Med (Maywood)

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show abstract

“…It improved oxygenation, reduced the inflammatory process and Histopathological damage, and attenuated oxidative lung injury compared to protective conventional mechanical ventilation [55,56]. Moreover, Jian et al [57] comparing conventional mechanical ventilation and HFOV, showed reduced inflammatory responses measured by tumor necrosis factor alpha (TNF-α) production and neutrophil infiltration in bronchoalveolar lavage fluid in a rat model of ALI. In agreement, Allardet-Servent et al [58] reported that HOFV ameliorates VILI in a rabbit model of ALI.…”

Section: High-frequency Oscillatory Ventilation As a Tool To Prevent mentioning

confidence: 99%

Ventilator-Induced Lug Injury and Acute Respiratory Distress Syndrome: A Basic Science Review

Ronchi¹

2012

J Pulm Respir Med

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Acute respiratory distress syndrome is the most severe manifestation of acute lung injury and it is associated with high mortality rate. Despite better understanding of ARDS pathophysiology, its mechanism is still unclear. Mechanical ventilation is the main ARDS supportive treatment. However, mechanical ventilation is a non-physiologic process and complications are associated with its application. Mechanical ventilation may induce lung injury, referred to as ventilator-induced lung injury. Frequently, VILI is related to macroscopic injuries associated with alveolar rupture. The present article is a review of the literature on ventilator-induced lung injury in acute respiratory distress syndrome. Animal and human studies were reviewed. We mainly selected publications in the past 5 years, but did not exclude commonly referenced and highly regarded older publications.

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“…2 High-frequency oscillatory ventilation (HFOV) is, at least theoretically, an ideal tool for lungprotective ventilation, as it allows pulmonary gas exchange using very small tidal volume (V T ) and decreases the risk of atelectrauma. [3][4][5][6][7][8][9][10][11][12][13][14][15] Animal studies have pointed out that HFOV might be preferable over conventional MV, given its more beneficial effects on oxygenation, lung compliance, attenuation of the pulmonary inflammation and histologic injury, and better alveolar stability. 16,17 HFOV allows the decoupling of oxygenation and ventilation.…”

Section: Introductionmentioning

confidence: 99%

Reflections on Pediatric High-Frequency Oscillatory Ventilation From a Physiologic Perspective

2012

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Mechanical ventilation using low tidal volumes has become universally accepted to prevent ventilator-induced lung injury. High-frequency oscillatory ventilation (HFOV) allows pulmonary gas exchange using very small tidal volume (1-2 mL/kg) with concomitant decreased risk of atelectrauma. However, its use in pediatric critical care varies between only 3% and 30% of all ventilated children. This might be explained by the fact that the beneficial effect of HFOV on patient outcome has not been ascertained. Alternatively, in contrast with present recommendations, one can ask if HFOV has been employed in its most optimal fashion related especially to the indications for and timing of HFOV, as well as to using the best oscillator settings. The first was addressed in one small randomized study showing that early use of HFOV, instead of rescue use, was associated with improved survival. From a physiologic perspective, the oscillator settings could be refined. Lung volume is the main determinant of oxygenation in diffuse alveolar disease, suggesting using an open-lung strategy by recruitment maneuvers, although this is in practice not custom. Using such an approach, the patient can be oscillated on the deflation limb of the pressurevolume (P-V) curve, allowing less pressure required to maintain a certain amount of lung volume. Gas exchange is determined by the frequency and the oscillatory power setting, controlling the magnitude of the membrane displacement. Experimental work as well as preliminary human data have shown that it is possible to achieve the smallest tidal volume with concomitant adequate gas exchange when oscillating at high frequency and high fixed power setting. Future studies are needed to validate these novel approaches and to evaluate their effect on patient outcome.

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Comparison of acid-induced inflammatory responses in the rat lung during high frequency oscillatory and conventional mechanical ventilation

Abstract: Background: The present study was performed to compare the effects of high frequency

Cited by 4 publications

References 26 publications

High-frequency oscillatory ventilation attenuates oxidative lung injury in a rabbit model of acute lung injury

High-frequency oscillatory ventilation attenuates oxidative lung injury in a rabbit model of acute lung injury

Ventilator-Induced Lug Injury and Acute Respiratory Distress Syndrome: A Basic Science Review

Reflections on Pediatric High-Frequency Oscillatory Ventilation From a Physiologic Perspective

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