title: Effect of different ventilatory strategies on local and systemic cytokine production in intact swine lungs in vivo.
abstract: The purpose of the study was to investigate the effect of different ventilatory strategies on local and systemic cytokine production in swine with intact lungs in vivo after 4 h of mechanical ventilation. Twenty-five swine were anesthetized and then randomized into five groups (n = 5): (1) low tidal volume zero PEEP (LVZP); (2) medium tidal volume zero PEEP (MVZP); (3) high tidal volume zero PEEP (HVZP); (4) low tidal volume PEEP (LVP); (4) high tidal volume PEEP (HVP). Respiratory rate was adjusted to maintain normocapnia and fraction of inspired oxygen (FiO2) was 1.0. TNF-alpha and IL-10 were measured in BALF and serum at baseline, 2 h, and 4 h of MV. One animal in LVZP (2 h) and two in HVP (3 h) group died before the end of the experiment. TNF-alpha level in BALF was significantly higher in LVZP and LVP at 4 h compared to baseline and the other groups. IL-10 level in BALF was significantly higher in LVP at 4h compared to baseline and the other groups. There was a statistically significant increase in serum TNF-alpha levels at 4 h in LVP group compared to baseline and the other groups at 4 h. There was statistically significant increase in serum IL-10 levels in HVZP and LVP groups at 2 and 4 h which was significantly higher compared to the other groups at 4 h. Our results show that a) low volume MV may induce local and systemic pro- and anti-inflammatory cytokine increase b) in the presence of pro-inflammatory cytokine response there is also an anti-inflammatory response in the same compartment (lungs, circulation). c) There maybe loss of alveolar-to-systemic cytokine compartmentalization.
authors.affiliation: Athens University School of Nursing, ICU at KAT Hospital, Athens Greece. pavlos_myrianthefs@hotmail.com
authors.forename: P
authors.initials: P
authors.lastname: Myrianthefs
authors.forename: E
authors.initials: E
authors.lastname: Boutzouka
authors.forename: K
authors.initials: K
authors.lastname: Venetsanou
authors.forename: A
authors.initials: A
authors.lastname: Papalois
authors.forename: M
authors.initials: M
authors.lastname: Kouloukousa
authors.forename: C
authors.initials: C
authors.lastname: Kittas
authors.forename: G
authors.initials: G
authors.lastname: Baltopoulos
mesh_terms: D000818:Animals; D001784:Blood Gas Analysis; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry / Q000166:cytology; D016207:Cytokines / Q000032:analysis / Q000097:blood / Q000378:metabolism*; D016753:Interleukin-10 / Q000032:analysis / Q000097:blood / Q000378:metabolism; D008168:Lung / Q000378:metabolism*; D008297:Male; D011014:Pneumonia / Q000209:etiology; D012121:Respiration, Artificial / Q000009:adverse effects / Q000379:methods; D013552:Swine; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000378:metabolism
chemical_list: D016207:Cytokines; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10