[Experimental treatment of acute lung injury caused by inundation of thoracic cavity by seawater following open chest wound].
OBJECTIVE
To study the effects of lung protective ventilation and pentoxifylline (PTX) on acute lung injury (ALI) caused by open chest wound with seawater inundation of the thoracic cavity.


METHODS
A model of ALI caused by open chest wound and seawater inundation of thoracic cavity was reproduced in dogs. Twenty-four healthy dogs were randomly divided into four groups: no-treatment group (group A), ordinary treatment group (group B), lung protective ventilation treatment group (group C), and lung protective ventilation and PTX treatment group (group D). The parameters of hemodynamics, arterial blood gas analysis, plasma osmotic pressure and serum electrolytes in dogs were determined at 0 and 6 hours after injury and at 2 and 4 hours after treatment. Blood samples and bronchoalveolar lavage fluid (BALF) were collected to assess the changes in cytokines including tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and IL-8.


RESULTS
The arterial oxygen partial pressure (PaO(2)) and oxygenation index (PaO(2)/FiO(2)) in group B were still lower than normal values at 2 and 4 hours after treatment, but those parameters in group C and group D distinctly recovered. The parameters of hemodynamics, plasma osmotic pressure and serum electrolytes were all normalized in group B, C and D at 2 and 4 hours after treatment compared with those in group A. The levels of TNF-alpha in peripheral blood in group C and the TNF-alpha and IL-8 levels in peripheral blood and IL-6, IL-8 levels in BALF in group D were significantly lower than those in group A and group B after treatment. The TNF-alpha in peripheral blood and IL-8 levels in BALF in group D were also significantly lower than those in group C after treatment.


CONCLUSIONS
Lung protective ventilation is an effective method in the treatment of ALI caused by open chest wound with inundation of seawater in thoracic cavity. PTX can inhibit inflammatory reaction in the lung and peripheral blood.
Duan
Yun-You
YY
Department of Respiratory Medicine, Naval General Hospital of PLA, Beijing, China.
Xue
Zhi-Qiang
ZQ
Meng
Ji-Guang
JG
Ding
Xin-Min
XM
Peng
Chao-Sheng
CS
Wang
Da-Peng
DP
D055371:Acute Lung Injury / Q000209:etiology / Q000628:therapy*; D000818:Animals; D001992:Bronchoalveolar Lavage Fluid; D004195:Disease Models, Animal; D004285:Dogs; D005260:Female; D007101:Immersion; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D010431:Pentoxifylline / Q000627:therapeutic use*; D012121:Respiration, Artificial / Q000379:methods*; D012623:Seawater; D035423:Thoracic Cavity; D013898:Thoracic Injuries / Q000150:complications; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D010431:Pentoxifylline