Hepatic effects of an open lung strategy and cardiac output restoration in an experimental lung injury

Kredel, Markus; Muellenbach, Ralf Michael; Hornung, Alexander; Schmidt, René; Laqua, Jessica; Brederlau, Joerg; Roewer, Norbert; Wunder, Christian

doi:10.1111/j.1399-6576.2009.02192.x

Cited by 3 publications

(16 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some data were partly presented in a publication evaluating hepatic effects of this experiment [8]: Inspiratory airway pressure, PEEP, cardiac output, heart rate, MAP, SvO 2 , fluid in-and output.…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, diagnostic bronchoalveolar lavage was done at baseline and at 6.5 hours, blood was drawn for laboratory tests, and liver tissue was examined. The results on hepatic effects of this experiment have been published elsewhere [8]. In [9].…”

Section: Animals and Preparationmentioning

confidence: 96%

“…The target PaO 2 at a FiO 2 of 1.0 was 60 to 100 mm Hg for 1 hour, before injury measurements were done. The lower inflection point of the pressure-volume curve was determined [8]. The animals were randomized into 3 groups (n = 8).…”

Section: Experimental Protocolmentioning

confidence: 99%

“…Twenty-four juvenile female Pietrain pigs weighing 52.8 ± 3.4 kg from a breed negative for the malignant hyperthermia gen were fasted without limiting water access. Premedication, induction, and maintenance of anesthesia (thiopental, fentanyl) and muscle relaxation (pancuronium bromide) were done as described before [8]. The pigs were placed supine.…”

Section: Animals and Preparationmentioning

confidence: 99%

“…Instrumentation with arterial and pulmonary artery catheters was done as described before [8]. For investigating hepatic effects, a liver vein catheter was inserted and flow probes were placed around hepatic blood vessels.…”

Section: Animals and Preparationmentioning

confidence: 99%

See 4 more Smart Citations

Pulmonary effects of positive end-expiratory pressure and fluid therapy in experimental lung injury

Kredel

Muellenbach

Schlegel

et al. 2010

Experimental Lung Research

View full text Add to dashboard Cite

The separate effects of positive end-expiratory pressure (PEEP) and intravascular volume administration on the histopathologic lung injury were not investigated in experimental lung injury previously. The authors hypothesized that high PEEP and a restrictive volume therapy would yield the best oxygenation and the least degree of lung injury. Pigs (52.8 ± 3.4 kg) underwent saline lavage-induced lung injury. The animals were ventilated either with low PEEP (mean PEEP 9 to 12 cm H₂O) and liberal volume therapy using hydroxyethyl starch (LowP/Vol+) or high PEEP (mean PEEP 21 cm H₂O) combined with recruitment maneuvers and liberal (HighP/Vol+) or restrictive volume therapy (HighP/Vol-). After 6.5 hours, lung injury was determined by using a histopathologic score evaluating overdistension, edema, exsudation, and inflammation. When volume therapy was liberal, high PEEP (HighP/Vol+) improved the Pao₂/Fio₂ index (416 ± 80 mm Hg) compared to low PEEP (LowP/Vol+, 189 ± 55 mm Hg; P < .05) but there was no difference in the median (interquartile range) lung injury score: 1.6 (1.2-1.9) and 1.9 (1.4-2.0). High PEEP with restrictive volume therapy (HighP/Vol-) did not further improve oxygenation (400 ± 55 mm Hg) but ameliorated the degree of lung injury: 0.9 (0.8-1.4) (P < .05). In lavage-induced lung injury, high PEEP improved oxygenation, but restrictive volume administration markedly reduced the lung injury score, mainly by reduced edema.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Animals and Preparationmentioning

confidence: 96%

Section: Experimental Protocolmentioning

confidence: 99%

Section: Animals and Preparationmentioning

confidence: 99%

Section: Animals and Preparationmentioning

confidence: 99%

See 3 more Smart Citations

Pulmonary effects of positive end-expiratory pressure and fluid therapy in experimental lung injury

Kredel

Muellenbach

Schlegel

et al. 2010

Experimental Lung Research

View full text Add to dashboard Cite

show abstract

Acute Respiratory Failure and Pulmonary Complications in End-Stage Liver Disease

Qadir

Wang

Chang

2018

Semin Respir Crit Care Med

View full text Add to dashboard Cite

Acute respiratory failure has a high mortality in patients with end-stage liver disease (ESLD). These patients may develop acute respiratory failure for reasons specific to advanced liver disease, including hepatopulmonary syndrome, portopulmonary hypertension, and hepatic hydrothorax. They may also develop respiratory complications due to conditions seen in the general intensive care unit population to which ESLD patients are at higher risk, including infection, volume overload, and the acute respiratory distress syndrome. Management of these patients is complicated and multifaceted, and a comprehensive understanding of the etiologies and treatment of acute respiratory failure is critical in this high-risk patient population. This article reviews current evidence surrounding the prevalence, management, and complications of the various etiologies of acute respiratory failure in ESLD patients.

show abstract

Hepatic effects of lung-protective pressure-controlled ventilation and a combination of high-frequency oscillatory ventilation and extracorporeal lung assist in experimental lung injury

et al. 2011

View full text Add to dashboard Cite

SummaryBackgroundVentilation with high positive end-expiratory pressure (PEEP) can lead to hepatic dysfunction. The aim of this study was to investigate the hepatic effects of strategies using high airway pressures either in pressure-controlled ventilation (PCV) or in high-frequency oscillatory ventilation (HFOV) combined with an arteriovenous extracorporeal lung assist (ECLA).Material/MethodsPietrain pigs underwent induction of lung injury by saline lavage. Ventilation was continued for 24 hours either as PCV with tidal volumes of 6 ml/kg and PEEP 3 cmH2O above the lower inflection point of the pressure-volume curve or as HFOV (≥12 Hz) with a mean tracheal airway pressure 3 cmH2O above the lower inflection point combined with arteriovenous ECLA (HFOV+ECLA). Fluids and norepinephrine stabilized the circulation. The indocyanine green plasma disappearance rate, serum bilirubin, aspartate aminotransferase, alanine aminotransferase, γ-glutamyltransferase, alkaline phosphatase, glutamate dehydrogenase, lactate dehydrogenase and creatine kinase were determined repeatedly. Finally, liver neutrophils were counted and liver cell apoptosis was assessed by terminal deoxynucleotidyl transferase nick end labeling (TUNEL).ResultsAspartate aminotransferase increased in the PCV group about three-fold and in the HFOV+ECLA group five-fold (p<0.001). Correspondingly, creatine kinase increased about two-fold and four-fold, respectively (p<0.001). Lactate dehydrogenase was increased in the HFOV+ECLA group (p<0.028). The number of neutrophils infiltrating the liver tissue and the apoptotic index were low.ConclusionsHigh airway pressure PCV and HFOV with ECLA in the treatment of lavage-induced lung injury in pigs did not cause liver dysfunction or damage. The detected elevation of enzymes might be of extrahepatic origin.

show abstract

Hepatic effects of an open lung strategy and cardiac output restoration in an experimental lung injury

Abstract: Open lung ventilation elicited neutrophil infiltration, but no liver dysfunction even without the stabilization of cardiac output.

Cited by 3 publications

References 36 publications

Pulmonary effects of positive end-expiratory pressure and fluid therapy in experimental lung injury

Pulmonary effects of positive end-expiratory pressure and fluid therapy in experimental lung injury

Acute Respiratory Failure and Pulmonary Complications in End-Stage Liver Disease

Hepatic effects of lung-protective pressure-controlled ventilation and a combination of high-frequency oscillatory ventilation and extracorporeal lung assist in experimental lung injury

Contact Info

Product

Resources

About