title: An experimental study on the impacts of inspiratory and expiratory muscles activities during mechanical ventilation in ARDS animal model.
abstract: In spite of intensive investigations, the role of spontaneous breathing (SB) activity in ARDS has not been well defined yet and little has been known about the different contribution of inspiratory or expiratory muscles activities during mechanical ventilation in patients with ARDS. In present study, oleic acid-induced beagle dogs' ARDS models were employed and ventilated with the same level of mean airway pressure. Respiratory mechanics, lung volume, gas exchange and inflammatory cytokines were measured during mechanical ventilation, and lung injury was determined histologically. As a result, for the comparable ventilator setting, preserved inspiratory muscles activity groups resulted in higher end-expiratory lung volume (EELV) and oxygenation index. In addition, less lung damage scores and lower levels of system inflammatory cytokines were revealed after 8 h of ventilation. In comparison, preserved expiratory muscles activity groups resulted in lower EELV and oxygenation index. Moreover, higher lung injury scores and inflammatory cytokines levels were observed after 8 h of ventilation. Our findings suggest that the activity of inspiratory muscles has beneficial effects, whereas that of expiratory muscles exerts adverse effects during mechanical ventilation in ARDS animal model. Therefore, for mechanically ventilated patients with ARDS, the demands for deep sedation or paralysis might be replaced by the strategy of expiratory muscles paralysis through epidural anesthesia.
authors.affiliation: Department of Respiratory Medicine, First Affiliated Hospital of Guizhou Medical University, Guizhou, China.
authors.forename: Xianming
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Respiratory Medicine, First Affiliated Hospital of Guizhou Medical University, Guizhou, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Du
authors.affiliation: Respiratory Mechanics Lab, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors.forename: Weiliang
authors.initials: W
authors.lastname: Wu
authors.affiliation: Respiratory Mechanics Lab, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors.forename: Yongcheng
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Respiratory Mechanics Lab, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Respiratory Mechanics Lab, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
authors.forename: Rongchang
authors.initials: R
authors.lastname: Chen
mesh_terms: D000818:Animals; D016207:Cytokines / Q000097:blood; D004285:Dogs; D045853:Exhalation; D001239:Inhalation; D008168:Lung / Q000473:pathology; D019301:Oleic Acid / Q000633:toxicity; D011175:Positive-Pressure Respiration / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D012132:Respiratory Muscles / Q000502:physiology*; D014939:Work of Breathing
chemical_list: D016207:Cytokines; D019301:Oleic Acid