title: Preemptive hemodynamic intervention restricting the administration of fluids attenuates lung edema progression in oleic acid-induced lung injury.
abstract: OBJECTIVE
  A study is made of the influence of preemptive hemodynamic intervention restricting fluid administration upon the development of oleic acid-induced lung injury.
  
  
  METHODS
  A randomized in vivo study in rabbits was carried out.
  
  
  METHODS
  University research laboratory.
  
  
  METHODS
  Sixteen anesthetized, mechanically ventilated rabbits.
  
  
  METHODS
  Hemodynamic measurements obtained by transesophageal Doppler signal. Respiratory mechanics computed by a least square fitting method. Lung edema assessed by the ratio of wet weight to dry weight of the right lung. Histological examination of the left lung.
  
  
  METHODS
  Animals were randomly assigned to either the early protective lung strategy (EPLS) (n=8) or the early protective hemodynamic strategy (EPHS) (n=8). In both groups, lung injury was induced by the intravenous infusion of oleic acid (OA) (0.133mlkg-1h-1for 2h). At the same time, the EPLS group received 15mlkg-1h-1of Ringer lactate solution, while the EPHS group received 30mlkg-1h-1. Measurements were obtained at baseline and 1 and 2h after starting OA infusion.
  
  
  RESULTS
  After 2h, the cardiac index decreased in the EPLS group (p<0.05), whereas in the EPHS group it remained unchanged. Lung compliance decreased significantly only in the EPHS group (p<0.05). Lung edema was greater in the EPHS group (p<0.05). Histological damage proved similar in both groups (p=0.4).
  
  
  CONCLUSIONS
  In this experimental model of early lung injury, lung edema progression was attenuated by preemptively restricting the administration of fluids.
authors.affiliation: Laboratorio de Investigación Experimental, Unidad de Gestión Clínica de Medicina Intensiva, Hospital del SAS de Jerez, Jerez de la Frontera, Cádiz, Spain. Electronic address: anselgil@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Gil Cano
authors.affiliation: Laboratorio de Investigación Experimental, Unidad de Gestión Clínica de Medicina Intensiva, Hospital del SAS de Jerez, Jerez de la Frontera, Cádiz, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Gracia Romero
authors.affiliation: Laboratorio de Investigación Experimental, Unidad de Gestión Clínica de Medicina Intensiva, Hospital del SAS de Jerez, Jerez de la Frontera, Cádiz, Spain.
authors.forename: M I
authors.initials: MI
authors.lastname: Monge García
authors.affiliation: Laboratorio de Investigación Experimental, Unidad de Gestión Clínica de Medicina Intensiva, Hospital del SAS de Jerez, Jerez de la Frontera, Cádiz, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Guijo González
authors.affiliation: Servicio de Anatomía Patológica, Hospital del SAS de Jerez, Jerez de la Frontera, Cádiz, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Ruiz Campos
mesh_terms: D000818:Animals; D018450:Disease Progression; D005440:Fluid Therapy / Q000379:methods*; D006439:Hemodynamics; D055370:Lung Injury / Q000209:etiology* / Q000517:prevention & control*; D019301:Oleic Acid / Q000008:administration & dosage; D011654:Pulmonary Edema / Q000139:chemically induced / Q000150:complications* / Q000503:physiopathology; D011817:Rabbits; D011897:Random Allocation; D012121:Respiration, Artificial
chemical_list: D019301:Oleic Acid
keywords: ARDS; Acute lung injury; Early protective lung strategy; Edema pulmonar; Estrategia precoz protectora pulmonar; Impactos secundarios; Intervención hemodinámica preventiva; Lesión pulmonar aguda; Mecánica respiratoria; Oleic acid; Preemptive hemodynamic intervention; Pulmonary edema; Respiratory mechanics; SDRA; Second hits; Ácido oleico