Experimental

Intensive Care Medicine

, 34:763

First online:

Terbutaline lessens protein fluxes across the alveolo-capillary barrier during high-volume ventilation

  • Nicolas de ProstAffiliated withINSERM U773, Equipe 11, Centre de Recherche Bichat Beaujon CRB3Site Xavier Bichat, Université Paris 7 Denis Diderot
  • , Didier DreyfussAffiliated withSite Xavier Bichat, Université Paris 7 Denis DiderotAssistance Publique – Hôpitaux de Paris, Service de Réanimation Médicale, Hôpital Louis Mourier
  • , Jean-Damien RicardAffiliated withSite Xavier Bichat, Université Paris 7 Denis DiderotAssistance Publique – Hôpitaux de Paris, Service de Réanimation Médicale, Hôpital Louis MourierINSERM U722
  • , Georges SaumonAffiliated withINSERM U773, Equipe 11, Centre de Recherche Bichat Beaujon CRB3Site Xavier Bichat, Université Paris 7 Denis Diderot Email author 

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

Objective

To evaluate whether a β2-adrenergic agonist may reduce acute alveolo-capillary barrier alterations during high-volume ventilation.

Design

Experimental study.

Setting

Animal research laboratory.

Subjects

A total of 48 male Wistar rats.

Interventions

A zone of alveolar flooding was produced by liquid instillation in a distal airway. Proteins in the instilled solution were traced with 99mTc-albumin. 111In, which binds to transferrin, was injected into the systemic circulation. Terbutaline was administered in the instilled solution or intra-peritoneally. Conventional ventilation was applied for 30 min followed by different ventilation strategies for 90 min: conventional ventilation, high-volume ventilation with or without 6 cmH2O PEEP.

Measurements and main results

Protein fluxes across the alveolar and microvascular barriers were evaluated by scintigraphy. High-volume ventilation resulted in immediate leakage of 99mTc-albumin from alveolar spaces and increased pulmonary uptake of systemic 111In-transferrin. Terbutaline in the instilled solution and PEEP lessened alveolar 99mTc-albumin leakage and pulmonary 111In-transferrin uptake due to high-volume ventilation, whereas terbutaline given intra-peritoneally only lessened 111In-transferrin uptake. Terbutaline in the instilled solution also lessened the increase in lung wet-to-dry weight ratio due to high-volume ventilation.

Conclusions

Terbutaline reduces protein fluxes across the alveolar epithelial and pulmonary microvascular barriers during high-volume ventilation in vivo. The route of administration may be important.

Keywords

Pulmonary edema Intermittent positive pressure ventilation Beta-adrenergic agonists Radionuclide imaging