title: Low Tidal Volume Reduces Lung Inflammation Induced by Liquid Ventilation in Piglets With Severe Lung Injury.
abstract: Total liquid ventilation (TLV) is an alternative treatment for severe lung injury. High tidal volume is usually required for TLV to maintain adequate CO2clearance. However, high tidal volume may cause alveolar barotrauma. We aim to investigate the effect of low tidal volume on pulmonary inflammation in piglets with lung injury and under TLV. After the establishment of acute lung injury model by infusing lipopolysaccharide, 12 piglets were randomly divided into two groups, TLV with high tidal volume (25 mL/kg) or with low tidal volume (6 mL/kg) for 240 min, respectively. Extracorporeal CO2removal was applied in low tidal volume group to improve CO2clearance and in high tidal volume group as sham control. Gas exchange and hemodynamic status were monitored every 30 min during TLV. At the end of the study, pulmonary mRNA expression and plasmatic concentration of interleukin-6 (IL-6) and interleukin-8 (IL-8) were measured by collecting lung tissue and blood samples from piglets. Arterial blood pressure, PaO2, and PaCO2showed no remarkable difference between groups during the observation period. Compared with high tidal volume strategy, low tidal volume resulted in 76% reduction of minute volume and over 80% reduction in peak inspiratory pressure during TLV. In addition, low tidal volume significantly diminished pulmonary mRNA expression and plasmatic level of IL-6 and IL-8. We conclude that during TLV, low tidal volume reduces lung inflammation in piglets with acute lung injury without compromising gas exchange.
authors.affiliation: Department of Cardiothoracic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou.
authors.forename: Lijun
authors.initials: L
authors.lastname: Jiang
authors.affiliation: Department of Cardiothoracic Surgery, Children's Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Huizhen
authors.initials: H
authors.lastname: Feng
authors.affiliation: Department of Cardiothoracic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou.
authors.forename: Xiaofan
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Cardiothoracic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou.
authors.forename: Kaifeng
authors.initials: K
authors.lastname: Liang
authors.affiliation: Department of Cardiothoracic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou.
authors.forename: Chengyao
authors.initials: C
authors.lastname: Ni
mesh_terms: D055371:Acute Lung Injury / Q000097:blood / Q000235:genetics / Q000503:physiopathology / Q000628:therapy*; D000818:Animals; D002245:Carbon Dioxide / Q000302:isolation & purification* / Q000378:metabolism; D005786:Gene Expression Regulation; D006439:Hemodynamics; D007249:Inflammation / Q000209:etiology* / Q000235:genetics / Q000503:physiopathology / Q000628:therapy*; D015850:Interleukin-6 / Q000097:blood / Q000235:genetics; D016209:Interleukin-8 / Q000097:blood / Q000235:genetics; D021061:Liquid Ventilation / Q000009:adverse effects* / Q000379:methods; D008168:Lung / Q000378:metabolism / Q000503:physiopathology*; D012333:RNA, Messenger / Q000032:analysis / Q000235:genetics; D013552:Swine; D013556:Swine, Miniature; D013990:Tidal Volume
chemical_list: D015850:Interleukin-6; D016209:Interleukin-8; D012333:RNA, Messenger; D002245:Carbon Dioxide
keywords: -Acute lung injury; -Low tidal volume; Total liquid ventilation