title: The protective effects of glutamine in a rat model of ventilator-induced lung injury.
abstract: BACKGROUND
  The mortality rate of patients with acute respiratory distress syndrome (ARDS) is still high despite the use of protective ventilatory strategies. We sought to examine the pharmacological effects of glutamine (GLN) in a two-hit model of endotoxin-induced inflammation followed by ventilator-induced lung injury (VILI). We hypothesized that the administration of GLN ameliorates the VILI.
  
  
  METHODS
  Sprague-Dawley rats were anesthetized and given lipopolysaccharide (LPS) intratracheally as a first hit to induce lung inflammation, followed 24 h later by a second hit of mechanical ventilation (MV) with either low tidal volume (6 mL/kg) with 5 cmH2O of positive end-expiratory pressure (PEEP) or high tidal volume (22 mL/kg) with zero PEEP for 4 h. GLN or lactated Ringer's solution as the placebo was administered intravenously 15 min prior to MV.
  
  
  RESULTS
  In the LPS-challenged rats ventilated with high tidal volume, the treatment with GLN improved lung injury indices, lung mechanics and cytokine responses compared with the placebo group.
  
  
  CONCLUSIONS
  The administration of GLN given immediately prior to MV may be beneficial in the context of reducing VILI.
authors.affiliation: 1 Department of Recreation and Healthcare Management, Chia Nan University of Pharmacy & Science, Tainan, Taiwan ; 2 Department of Critical Care Medicine, Chi-Mei Medical Center and Chang Jung Christian University, Tainan, Taiwan ; 3 Section of Respiratory Care, Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan ; 4 Department of Safety Health and Environment Engineering, Chung Hwa University of Medical Technology, Tainan, Taiwan ; 5 Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan ; 6 Keenan Research Center for Biomedical Science of St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
authors.forename: Chin-Ming
authors.initials: CM
authors.lastname: Chen
authors.affiliation: 1 Department of Recreation and Healthcare Management, Chia Nan University of Pharmacy & Science, Tainan, Taiwan ; 2 Department of Critical Care Medicine, Chi-Mei Medical Center and Chang Jung Christian University, Tainan, Taiwan ; 3 Section of Respiratory Care, Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan ; 4 Department of Safety Health and Environment Engineering, Chung Hwa University of Medical Technology, Tainan, Taiwan ; 5 Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan ; 6 Keenan Research Center for Biomedical Science of St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
authors.forename: Kuo-Chen
authors.initials: KC
authors.lastname: Cheng
authors.affiliation: 1 Department of Recreation and Healthcare Management, Chia Nan University of Pharmacy & Science, Tainan, Taiwan ; 2 Department of Critical Care Medicine, Chi-Mei Medical Center and Chang Jung Christian University, Tainan, Taiwan ; 3 Section of Respiratory Care, Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan ; 4 Department of Safety Health and Environment Engineering, Chung Hwa University of Medical Technology, Tainan, Taiwan ; 5 Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan ; 6 Keenan Research Center for Biomedical Science of St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
authors.forename: Chien-Feng
authors.initials: CF
authors.lastname: Li
authors.affiliation: 1 Department of Recreation and Healthcare Management, Chia Nan University of Pharmacy & Science, Tainan, Taiwan ; 2 Department of Critical Care Medicine, Chi-Mei Medical Center and Chang Jung Christian University, Tainan, Taiwan ; 3 Section of Respiratory Care, Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan ; 4 Department of Safety Health and Environment Engineering, Chung Hwa University of Medical Technology, Tainan, Taiwan ; 5 Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan ; 6 Keenan Research Center for Biomedical Science of St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
authors.forename: Haibo
authors.initials: H
authors.lastname: Zhang
keywords: Acute respiratory distress syndrome (ARDS); cytokines; glutamine (GLN); mechanical ventilation (MV)