title: The protective effect of different airway humidification liquids to lung after tracheotomy in traumatic brain injury: The role of pulmonary surfactant protein-A (SP-A).
abstract: The purpose of this study was to establish a rat model of a brain injury with tracheotomy and compared the wetting effects of different airway humidification liquids, afterward, the best airway humidification liquid was selected for the clinical trial, thus providing a theoretical basis for selecting a proper airway humidification liquid in a clinical setting. Rats were divided into a sham group, group A (0.9% NaCl), group B (0.45% NaCl), group C (0.9% NaCl+ambroxol) and group D (0.9% NaCl+Pulmicort). An established rat model of traumatic brain injury with tracheotomy was used. Brain tissue samples were taken to determine water content, while lung tissue samples were taken to determine wet/dry weight ratio (W/D), histological changes and expression levels of SP-A mRNA and SP-A protein. 30 patients with brain injury and tracheotomy were selected and divided into two groups based on the airway humidification liquid instilled in the trachea tube, 0.45% NaCl and 0.9% NaCl+ambroxol. Blood was then extracted from the patients to measure the levels of SP-A, interleukin-6 (IL-6), interleukin-8 (IL-8) and tumour necrosis factor-α (TNF-α). The difference between group C and other groups in lung W/D and expression levels of SP-A mRNA and SP-A protein was significant (P<0.05). In comparison, the histological changes showed that the lung tissue damage was smallest in group C compared to the three other groups. Aspect of patients, 0.45% NaCl group and 0.9% NaCl+ambroxol group were significantly different in the levels of SP-A, IL-6, IL-8 and TNF-α (P<0.01). In the present study, 0.9% NaCl+ambroxol promote the synthesis and secretion of pulmonary surfactant, and has anti-inflammatory and antioxidant effects, which inhibit the release of inflammatory factors and cytokines, making it an ideal airway humidification liquid.
authors.affiliation: Department of Nursing, Binzhou Medical University, Yantai, China.
authors.forename: Xinyang
authors.initials: X
authors.lastname: Su
authors.affiliation: Department of Neurosurgery Medicine, Affiliated Hospital of Binzhou Medical University, Binzhou, China.
authors.forename: Zefu
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Nursing Department, Affiliated Hospital of Binzhou Medical University, Binzhou, China.
authors.forename: Meilin
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery Medicine, Affiliated Hospital of Binzhou Medical University, Binzhou, China.
authors.forename: Zhenzhu
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Neurosurgery Medicine, Affiliated Hospital of Binzhou Medical University, Binzhou, China.
authors.forename: Qingbo
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Clinical Medicine, Binzhou Medical University, Yantai, China.
authors.forename: Wenxian
authors.initials: W
authors.lastname: Lu
authors.affiliation: Department of Nursing, Binzhou Medical University, Yantai, China.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Rehabilitation Medicine, Binzhou Medical University, Yantai, China.
authors.forename: Youfei
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of Organization and Personnel Department, Affiliated Hospital of Binzhou Medical University, Binzhou, China. Electronic address: hmx58@163.com.
authors.forename: Hongmei
authors.initials: H
authors.lastname: Xu
mesh_terms: D000328:Adult; D000551:Ambroxol / Q000494:pharmacology*; D000818:Animals; D001921:Brain / Q000473:pathology; D001923:Brain Chemistry; D001930:Brain Injuries / Q000188:drug therapy* / Q000473:pathology; D019819:Budesonide / Q000494:pharmacology*; D004195:Disease Models, Animal; D006801:Humans; D006813:Humidity; D008168:Lung / Q000737:chemistry / Q000473:pathology; D008297:Male; D008875:Middle Aged; D037662:Pulmonary Surfactant-Associated Protein A / Q000378:metabolism*; D011663:Pulmonary Surfactants / Q000378:metabolism*; D051381:Rats; D017207:Rats, Sprague-Dawley; D012965:Sodium Chloride; D014140:Tracheotomy
chemical_list: D037662:Pulmonary Surfactant-Associated Protein A; D011663:Pulmonary Surfactants; D000551:Ambroxol; D012965:Sodium Chloride; D019819:Budesonide
keywords: Ambroxol; Brain injuries; Humidification; Surfactant protein A; Tracheotomy