title: Healthy lung tissue response to mechanical ventilation in an experimental porcine model.
abstract: BACKGROUND
  The aim of this comparative study was to assess the impact of two different settings of tidal volume (Vt) on the function and morphology of the mechanically ventilated lungs during a 12-h period.
  
  
  METHODS
  A total of 32 animals were randomly divided into two groups. Group A included piglets ventilated with a Vt of 6 ml/kg and group B piglets ventilated with a Vt of 10 ml/kg. Lung functions and pulmonary mechanics were evaluated after 1 and 12 h of mechanical ventilation. Morphological changes of the lung tissue were evaluated at the end of the study.
  
  
  RESULTS
  Twelve hours of lower Vt ventilation was associated with the development of respiratory acidosis but minimal histological changes. Higher Vt led to pronounced histological changes in terms of proliferation and apoptosis and a decrease of dynamic compliance, with a trend towards lower oxygenation during the study.
  
  
  CONCLUSIONS
  Mechanical ventilation with a Vt of 6 ml/kg induces minimal histological lung parenchymal changes in terms of proliferation and apoptosis. Positive pressure mechanical ventilation with Vt of 10 ml/kg does not protect lung tissue and induces substantial proliferative and apoptotic changes within the lung parenchyma. Positive pressure mechanical ventilation with Vt of 10 ml/kg does not guarantee protection of healthy pulmonary tissue in the absence of a priming pulmonary insult.
authors.affiliation: Pediatric intensive care unit (PICU), Department of Pediatrics, Faculty of Medicine, Charles University of Prague in Pilsen, Pilsen, Czech Republic fremuthj@gmail.com.
authors.forename: Jiri
authors.initials: J
authors.lastname: Fremuth
authors.affiliation: Pediatric intensive care unit (PICU), Department of Pediatrics, Faculty of Medicine, Charles University of Prague in Pilsen, Pilsen, Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Kobr
authors.affiliation: Pediatric intensive care unit (PICU), Department of Pediatrics, Faculty of Medicine, Charles University of Prague in Pilsen, Pilsen, Czech Republic.
authors.forename: Katerina
authors.initials: K
authors.lastname: Pizingerova
authors.affiliation: Pediatric intensive care unit (PICU), Department of Pediatrics, Faculty of Medicine, Charles University of Prague in Pilsen, Pilsen, Czech Republic.
authors.forename: Lumir
authors.initials: L
authors.lastname: Sasek
authors.affiliation: Pediatric intensive care unit (PICU), Department of Pediatrics, Faculty of Medicine, Charles University of Prague in Pilsen, Pilsen, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Jehlicka
authors.affiliation: Pediatric intensive care unit (PICU), Department of Pediatrics, Faculty of Medicine, Charles University of Prague in Pilsen, Pilsen, Czech Republic.
authors.forename: Jana
authors.initials: J
authors.lastname: Zamboryova
authors.affiliation: Šikl Institute of Pathological Anatomy, Faculty of Medicine, Charles University of Prague in Pilsen, Pilsen, Czech Republic.
authors.forename: Ondrej
authors.initials: O
authors.lastname: Hess
authors.affiliation: Central Laboratory of Immunoanalysis, Faculty of Medicine, Charles University of Prague in Pilsen, Pilsen, Czech Republic.
authors.forename: Jana
authors.initials: J
authors.lastname: Vrzalova
authors.affiliation: Department of Clinical Biochemistry and Hematology, Faculty of Medicine, Charles University of Prague in Pilsen, Pilsen, Czech Republic.
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Racek
authors.affiliation: Department of Histology and Embryology, Faculty of Medicine, Charles University of Prague in Pilsen, Pilsen, Czech Republic Biomedical Centre, Faculty of Medicine, Charles University of Prague in Pilsen, Pilsen, Czech Republic.
authors.forename: Zbynek
authors.initials: Z
authors.lastname: Tonar
mesh_terms: D000818:Animals; D017209:Apoptosis; D053148:Caspase 3 / Q000378:metabolism; D049109:Cell Proliferation; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000378:metabolism; D008168:Lung / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology*; D023421:Models, Animal; D012121:Respiration, Artificial / Q000009:adverse effects; D012129:Respiratory Function Tests; D013552:Swine; D013990:Tidal Volume; D013997:Time Factors
chemical_list: D019394:Ki-67 Antigen; D053148:Caspase 3
keywords: Mechanical ventilation; apoptosis; injury; lung; proliferation piglets