Intensive Care Medicine

, Volume 35, Issue 6, pp 1120–1128

Effects of frequency and inspiratory plateau pressure during recruitment manoeuvres on lung and distal organs in acute lung injury

Authors

  • Paula W. Steimback
    • Laboratory of Pulmonary Investigation, Instituto de Biofísica Carlos Chagas Filho, C.C.S.Universidade Federal do Rio de Janeiro
  • Gisele P. Oliveira
    • Laboratory of Pulmonary Investigation, Instituto de Biofísica Carlos Chagas Filho, C.C.S.Universidade Federal do Rio de Janeiro
  • Andréia F. Rzezinski
    • Laboratory of Pulmonary Investigation, Instituto de Biofísica Carlos Chagas Filho, C.C.S.Universidade Federal do Rio de Janeiro
  • Pedro L. Silva
    • Laboratory of Pulmonary Investigation, Instituto de Biofísica Carlos Chagas Filho, C.C.S.Universidade Federal do Rio de Janeiro
  • Cristiane S. N. B. Garcia
    • Laboratory of Pulmonary Investigation, Instituto de Biofísica Carlos Chagas Filho, C.C.S.Universidade Federal do Rio de Janeiro
  • Graziela Rangel
    • Laboratory of Cellular and Molecular Physiology, Carlos Chagas Filho Institute of Biophysics
  • Marcelo M. Morales
    • Laboratory of Cellular and Molecular Physiology, Carlos Chagas Filho Institute of Biophysics
  • José R. Lapa e Silva
    • Department of PneumologyFederal University of Rio de Janeiro
  • Vera L. Capelozzi
    • Department of PathologyUniversity of São Paulo
  • Paolo Pelosi
    • Department of Ambient, Health and SafetyUniversity of Insubria
    • Laboratory of Pulmonary Investigation, Instituto de Biofísica Carlos Chagas Filho, C.C.S.Universidade Federal do Rio de Janeiro
Experimental

DOI: 10.1007/s00134-009-1439-y

Cite this article as:
Steimback, P.W., Oliveira, G.P., Rzezinski, A.F. et al. Intensive Care Med (2009) 35: 1120. doi:10.1007/s00134-009-1439-y

Abstract

Purpose

To evaluate the effects of frequency and inspiratory plateau pressure (Pplat) during recruitment manoeuvres (RMs) on lung and distal organs in acute lung injury (ALI).

Methods

We studied paraquat-induced ALI rats. At 24 h, rats were anesthetized and RMs were applied using continuous positive airway pressure (CPAP, 40 cmH2O/40 s) or three-different sigh strategies: (a) 180 sighs/h and Pplat = 40 cmH2O (S180/40), (b) 10 sighs/h and Pplat = 40 cmH2O (S10/40), and (c) 10 sighs/h and Pplat = 20 cmH2O (S10/20).

Results

S180/40 yielded alveolar hyperinflation and increased lung and kidney epithelial cell apoptosis as well as type III procollagen (PCIII) mRNA expression. S10/40 resulted in a reduction in epithelial cell apoptosis and PCIII expression. Static elastance and alveolar collapse were higher in S10/20 than S10/40.

Conclusions

The reduction in sigh frequency led to a protective effect on lung and distal organs, while the combination with reduced Pplat worsened lung mechanics and histology.

Keywords

Acute lung injurySighVentilator-induced lung injuryTranspulmonary pressureApoptosis

Supplementary material

134_2009_1439_MOESM1_ESM.doc (2.5 mb)
Supplementary material 1 (DOC 2524 kb)

Copyright information

© Springer-Verlag 2009