Application of the open-lung concept during positive-pressure ventilation reduces pulmonary inflammation in newborn piglets.
It has been shown that application of the open-lung concept (OLC) during high-frequency oscillatory ventilation (HFOV) attenuates pulmonary inflammation. We hypothesized that this attenuation could also be achieved by applying the OLC during positive-pressure ventilation (PPV). After repeated whole-lung lavage, newborn piglets were assigned to one of three ventilation groups: (1) PPV(OLC); (2) HFOV(OLC), or (3) conventional PPV (PPV(CON)). After a ventilation period of 5 h, analysis of bronchoalveolar lavage fluid showed a reduced influx of polymorphonuclear neutrophils, interleukin 8, and thrombin activity in both OLC groups as compared with the PPV(CON) group. There were no differences in tumor necrosis factor alpha levels. We conclude that application of the OLC during PPV reduces pulmonary inflammation as compared with conventional PPV and that the magnitude of this reduction is comparable to that of HFOV.
Department of Neonatology, Emma Children's Hospital AMC, University of Amsterdam, The Netherlands. a.h.vankaam@amc.uva.nl
Anton H
AH
van Kaam
Willem A
WA
Dik
Jack J
JJ
Haitsma
Anne
A
De Jaegere
Birgitta A
BA
Naber
Wim M
WM
van Aalderen
Joke H
JH
Kok
Burkhard
B
Lachmann
D000818:Animals; D000831:Animals, Newborn; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry / Q000166:cytology; D016209:Interleukin-8 / Q000032:analysis; D007958:Leukocyte Count; D009504:Neutrophils; D011014:Pneumonia / Q000517:prevention & control*; D011175:Positive-Pressure Respiration / Q000379:methods*; D013552:Swine; D013917:Thrombin / Q000032:analysis; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D013917:Thrombin