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首页> 外文期刊>American Journal of Physiology >Lung epithelial injury markers are not influenced by use of lower tidal volumes during elective surgery in patients without preexisting lung injury
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Lung epithelial injury markers are not influenced by use of lower tidal volumes during elective surgery in patients without preexisting lung injury

机译：没有肺损伤的患者在择期手术中使用较低的潮气量不会影响肺上皮损伤标志物

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First published December 14, 2007; doi:10.1152/ajplung.00268.2007.--Clara cell protein levels are elevated in plasma of individuals with mild or subclinical lung injury. We studied the influence of two mechanical ventilation strategies on local and systemic levels of Clara cell protein (CC16) and compared them with levels of soluble receptor for advanced glycation end products (sRAGE) and surfactant proteins (SP)-A and -D in patients undergoing elective surgery. Saved samples from a previously reported investigation were used for the study. Forty patients planned for elective surgery were randomized to mechanical ventilation with either a conventional tidal volume (VT) of 12 ml/kg without positive end-expiratory pressure (PEEP) or low VT of 6 ml/kg and 10 cmHaO PEEP. Plasma and bronchoalveolar lavage fluid (BALF) was collected directly after intubation and after 5 h of mechanical ventilation. While systemic levels of SP-A and SP-D remained unchanged, systemic levels of CC16 and sRAGE increased significantly in both groups after 5 h (P < 0.001 for both). BALF levels of SP-A, SP-D, CC16, and sRAGE remained unaffected. No differences were found between the two mechanical ventilation strategies regarding any of the measured biological markers. In conclusion, systemic levels of CC16 and sRAGE rise after 5 h in patients receiving mechanical ventilation for elective surgery. Mechanical ventilation with lower tidal volumes and PEEP did not have a different effect on levels of biomarkers of lung epithelial injury compared with conventional mechanical ventilation.
机译：首次发布于2007年12月14日; doi：10.1152 / ajplung.00268.2007 .--轻度或亚临床肺损伤患者血浆中的Clara细胞蛋白水平升高。我们研究了两种机械通气策略对局部和全身性Clara细胞蛋白（CC16）的影响，并将其与患者晚期糖基化终产物（sRAGE）和表面活性剂蛋白（SP）-A和-D的可溶性受体水平进行了比较进行选择性手术。使用先前报告的调查中保存的样本进行研究。计划进行择期手术的40名患者被随机分配至机械通气，其常规潮气量（VT）为12 ml / kg，无呼气末正压（PEEP），或低VT为6 ml / kg和10 cmHaO PEEP。插管后和机械通气5 h后直接收集血浆和支气管肺泡灌洗液（BALF）。尽管SP-A和SP-D的全身水平保持不变，但5小时后两组的CC16和sRAGE全身水平均显着增加（两组P均<0.001）。 SP-A，SP-D，CC16和sRAGE的BALF水平保持不变。两种机械通气策略之间在任何测量到的生物学指标上均未发现差异。总之，接受择期手术机械通气的患者在5 h后全身CC16和sRAGE水平升高。与常规机械通气相比，低潮气量和PEEP的机械通气对肺上皮损伤的生物标志物水平没有影响。

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