Massive brain injury enhances lung damage in an isolated lung model of ventilator-induced lung injury.
OBJECTIVE
To assess the influence of massive brain injury on pulmonary susceptibility to injury attending subsequent mechanical or ischemia/reperfusion stress.


METHODS
Prospective experimental study.


METHODS
Animal research laboratory.


METHODS
Twenty-four anesthetized New Zealand White rabbits randomized to control (n = 12) or induced brain injury (n = 12) group.


METHODS
After randomization, brain injury was induced by inflation of an intracranial balloon-tipped catheter, and animals were ventilated with a tidal volume of 10 mL/kg and zero end-expiratory pressure for 120 mins. Following heart-lung block extraction, isolated and perfused lungs were subjected to injurious ventilation with peak airway pressure 30 cm H2O and positive end-expiratory pressure 5 cm H2O for 30 mins.


RESULTS
No difference was observed between groups in gas exchange, lung mechanics, or hemodynamics during the 2-hr in vivo period following induction of brain injury. However, after 30 mins of ex vivo injurious mechanical ventilation, lungs from the brain injury group showed greater change in ultrafiltration coefficient, weight gain, and alveolar hemorrhage (all p < .05).


CONCLUSIONS
Massive brain injury might increase lung vulnerability to subsequent injurious mechanical or ischemia-reperfusion insults, thereby increasing the risk of clinical posttransplant graft failure.
López-Aguilar
Josefina
J
Hospital de Sabadell, Institut Universitari Parc Taulí, Universitat Autònoma de Barcelona, Spain.
Villagrá
Ana
A
Bernabé
Francesca
F
Murias
Gastón
G
Piacentini
Enrique
E
Real
Jordi
J
Fernández-Segoviano
Pilar
P
Romero
Pablo V
PV
Hotchkiss
John R
JR
Blanch
Lluis
L
D000818:Animals; D001930:Brain Injuries / Q000150:complications*; D004195:Disease Models, Animal; D011175:Positive-Pressure Respiration; D011659:Pulmonary Gas Exchange; D011817:Rabbits; D012121:Respiration, Artificial / Q000009:adverse effects*; D012128:Respiratory Distress Syndrome / Q000209:etiology* / Q000473:pathology