High tidal volume ventilation induces lung injury after hepatic ischemia-reperfusion.
Ischemia-reperfusion not only damages the affected organ but also leads to remote organ injuries. Hepatic inflow interruption usually occurs during hepatic surgery. To investigate the influence of liver ischemia-reperfusion on lung injury and to determine the contribution of tidal volume settings on liver ischemia-reperfusion-induced lung injury, we studied anesthetized and mechanically ventilated rats in which the hepatic inflow was transiently interrupted twice for 15 min. Two tidal volumes, 6 ml/kg as a low tidal volume (IR-LT) and 24 ml/kg as a high tidal volume (IR-HT), were assessed after liver ischemia-reperfusion, as well as after a sham operation, 6 ml/kg (NC-LT) and 24 ml/kg (NC-HT). Both the IR-HT and IR-LT groups had a gradual decline in the systemic blood pressure and a significant increase in plasma TNF-alpha concentrations. Of the four groups, only the IR-HT group developed lung injury, as assessed by an increase in the lung wet-to-dry weight ratio, the presence of significant histopathological changes, such as perivascular edema and intravascular leukocyte aggregation, and an increase in the bronchoalveolar lavage fluid TNF-alpha concentration. Furthermore, only in the IR-HT group was airway pressure increased significantly during the 6-h reperfusion period. These findings suggest that liver ischemia-reperfusion caused systemic inflammation and that lung injury is triggered when high tidal volume ventilation follows liver ischemia-reperfusion.
Ota
Shuhei
S
Department of Anesthesiology and Critical Care Medicine, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan.
Nakamura
Kyota
K
Yazawa
Takuya
T
Kawaguchi
Yosuke
Y
Baba
Yasuko
Y
Kitaoka
Ritsuko
R
Morimura
Naoto
N
Goto
Takahisa
T
Yamada
Yoshitsugu
Y
Kurahashi
Kiyoyasu
K
D000818:Animals; D001992:Bronchoalveolar Lavage Fluid; D007958:Leukocyte Count; D008099:Liver / Q000098:blood supply*; D008107:Liver Diseases / Q000150:complications* / Q000503:physiopathology; D008171:Lung Diseases / Q000209:etiology*; D008297:Male; D012123:Pulmonary Ventilation; D051381:Rats; D017207:Rats, Sprague-Dawley; D015427:Reperfusion Injury / Q000150:complications* / Q000503:physiopathology; D013990:Tidal Volume; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D014409:Tumor Necrosis Factor-alpha