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首页> 外文期刊>American Journal of Physiology >Choosing the frequency of deep inflation in mice: balancing recruitment against ventilator-induced lung injury.
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Choosing the frequency of deep inflation in mice: balancing recruitment against ventilator-induced lung injury.

机译：选择小鼠深部充血的频率：平衡呼吸机诱发的肺损伤的募集。

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摘要

Low tidal volume (Vt) ventilation is protective against ventilator-induced lung injury but can promote development of atelectasis. Periodic deep inflation (DI) can open the lung, but if delivered too frequently may cause damage via repeated overdistention. We therefore examined the effects of varying DI frequency on lung mechanics, gas exchange, and biomarkers of injury in mice. C57BL/6 males were mechanically ventilated with positive end-expiratory pressure (PEEP) of 2 cmH2O for 2 h. One high Vt group received a DI with each breath (HV). Low Vt groups received 2 DIs after each hour of ventilation (LV) or 2 DIs every minute (LVDI). Control groups included a nonventilated surgical sham and a group receiving high Vt with zero PEEP (HVZP). Respiratory impedance was measured every 4 min, from which tissue elastance (H) and damping (G) were derived. G and H rose progressively during LV and HVZP, but returned to baseline after hourly DI during LV. During LVDI and HV, G and H remained low and gas exchange wassuperior to that of LV. Bronchoalveolar lavage fluid protein was elevated in HV and HVZP but was not different between LV and LVDI. Lung tissue IL-6 and IL-1beta levels were elevated in HVZP and lower in LVDI compared with LV. We conclude that frequent DI can safely improve gas exchange and lung mechanics and may confer protection from biotrauma. Differences between LVDI and HV suggest that an optimal frequency range of DI exists, within which the benefits of maintaining an open lung outweigh injury incurred from overdistention.
机译：低潮气量（Vt）通风可防止呼吸机引起的肺损伤，但可促进肺不张的发展。周期性的深部充血（DI）可以打开肺部，但是如果输送的太频繁，则可能由于反复过度膨胀而造成损害。因此，我们检查了不同DI频率对小鼠肺部力学，气体交换和损伤生物标志物的影响。使用2 cmH2O的呼气末正压（PEEP）对C57BL / 6雄性进行机械通气2 h。一个高Vt组在每次呼吸（HV）时接受DI。低Vt组在通气（LV）每小时后接受2 DI，或者每分钟（LVDI）2 DI。对照组包括不通风的假手术组和接受高Vt且PEEP为零（HVZP）的组。每4分钟测量一次呼吸阻抗，从中得出组织弹性（H）和阻尼（G）。在LV和HVZP期间，G和H逐渐升高，但在LV期间每小时进行DI后，G和H返回基线。在LVDI和HV期间，G和H保持较低，并且气体交换优于LV。 HV和HVZP中支气管肺泡灌洗液蛋白升高，但LV和LVDI之间无差异。与LV相比，HVZP的肺组织IL-6和IL-1beta水平升高，而LVDI则更低。我们得出的结论是，频繁的DI可以安全地改善气体交换和肺部力学，并且可以提供生物创伤保护。 LVDI和HV之间的差异表明存在最佳的DI频率范围，在该频率范围内，保持肺开放张开的益处胜过过度扩张引起的伤害。

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