Total body response to mechanical ventilation of healthy lungs: an experimental study in piglets.
The objective of our study was to assess the influence of mechanical ventilation on healthy body organs. Fifteen piglets (aged 6 weeks, 19-27 kg) were anesthetized, instrumented, and divided into three groups: Group A - spontaneously breathing, group B - mechanically ventilated with tidal volume 6 ml/kg, and group C - ventilated with tidal volume 10 ml/kg for 12 hours. The parameters of lung, heart, liver and kidney functions neurohumoral regulation and systemic inflammatory reaction were recorded initially (time-1) and after 12 hours (time-12) of mechanical ventilation. At the onset of experiment (time-1) the levels of soluble adhesive molecules were higher (CAM; P<0.01), glomerular filtration index and free water clearance were lower (P<0.05) in both ventilated groups than in group A. Right ventricle myocardial performance index was higher (RIMP; P<0.05) in group C when compared with group A. Levels of CAM (P<0.05) and creatinine clearance (P<0.01) were higher, free water clearance was lower (P<0.05) in group C when compared to group B. At time-12 the RIMP (P<0.05) and levels of CAM were increased (P<0.01), creatinine clearance was decreased (P<0.05) in both ventilated groups compared to the same parameter at time-1. Ventilation index was higher (P<0.05), and hypoxemic index was lower (P<0.01) in group C when compared to group B. In conclusion, this study showed that mechanical ventilation induced changes compatible with early inflammatory response in healthy animals. Higher tidal volumes had detrimental effect on ventilatory parameters, reduced myocardial performance and potentiated adverse reaction of other organs.
Kobr
J
J
Department of Paediatrics, PICU, Charles University in Prague, Faculty Hospital in Pilsen, Pilsen, Czech Republic. kobr@fnplzen.cz
Fremuth
J
J
Pizingerová
K
K
Fikrlová
S
S
Jehlicka
P
P
Honomichl
P
P
Sasek
L
L
Racek
J
J
Topolcan
O
O
D000818:Animals; D000831:Animals, Newborn; D015415:Biomarkers / Q000097:blood / Q000652:urine; D015815:Cell Adhesion Molecules / Q000097:blood; D003404:Creatinine / Q000097:blood / Q000652:urine; D004231:Diuresis; D005260:Female; D005919:Glomerular Filtration Rate; D007249:Inflammation / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D018836:Inflammation Mediators / Q000097:blood; D008168:Lung / Q000503:physiopathology*; D008297:Male; D009200:Myocardial Contraction; D012121:Respiration, Artificial / Q000009:adverse effects*; D013552:Swine; D013990:Tidal Volume; D013997:Time Factors; D016278:Ventricular Function, Right
D015415:Biomarkers; D015815:Cell Adhesion Molecules; D018836:Inflammation Mediators; D003404:Creatinine