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The Effects of Prone Position Ventilation on Experimental Mild Acute Lung Injury Induced by Intraperitoneal Lipopolysaccharide Injection in Rats

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Abstract

Introduction

The benefits of prone position ventilation are well demonstrated in the severe forms of acute respiratory distress syndrome, but not in the milder forms. We investigated the effects of prone position on arterial blood gases, lung inflammation, and histology in an experimental mild acute lung injury (ALI) model.

Methods

ALI was induced in Wistar rats by intraperitoneal Escherichia coli lipopolysaccharide (LPS, 5 mg/kg). After 24 h, the animals with PaO2/FIO2 between 200 and 300 mmHg were randomized into 2 groups: prone position (n = 6) and supine position (n = 6). Both groups were compared with a control group (n = 5) that was ventilated in the supine position. All of the groups were ventilated for 1 h with volume-controlled ventilation mode (tidal volume = 6 ml/kg, respiratory rate = 80 breaths/min, positive end-expiratory pressure = 5 cmH2O, inspired oxygen fraction = 1)

Results

Significantly higher lung injury scores were observed in the LPS-supine group compared to the LPS-prone and control groups (0.32 ± 0.03; 0.17 ± 0.03 and 0.13 ± 0.04, respectively) (p < 0.001), mainly due to a higher neutrophil infiltration level in the interstitial space and more proteinaceous debris that filled the airspaces. Similar differences were observed when the gravity-dependent lung regions and non-dependent lung regions were analyzed separately (p < 0.05). The BAL neutrophil content was also higher in the LPS-supine group compared to the LPS-prone and control groups (p < 0.05). There were no significant differences in the wet/dry ratio and gas exchange levels.

Conclusions

In this experimental extrapulmonary mild ALI model, prone position ventilation for 1 h, when compared with supine position ventilation, was associated with lower lung inflammation and injury.

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Acknowledgments

This study was funded by a research grant from Rede Mineira TOXIFAR, Fundação de Amparo a Pesquisa do Estado de Minas Gerais (FAPEMIG), Center of Reproductive Biology, and Programa de Apoio ao Recém-Doutor/Propesq/UFJF (2013/2014).

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Authors and Affiliations

  1. Pulmonary Research Laboratory, Hospital Universitário da Universidade Federal de Juiz de Fora, Av. Eugênio do Nascimento - s/nº, Dom Bosco, Juiz de Fora, MG, 36038-330, Brazil

    Aydra Mendes Almeida Bianchi, Maycon Moura Reboredo, Leda Marília Fonseca Lucinda, Fernando Fonseca Reis, Manfrinni Vinícius Alves Silva, Maria Aparecida Esteves Rabelo, Júlio César Abreu Oliveira & Bruno do Valle Pinheiro

  2. Center of Reproductive Biology, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil

    Aydra Mendes Almeida Bianchi, Maycon Moura Reboredo, Leda Marília Fonseca Lucinda, Fernando Fonseca Reis, Manfrinni Vinícius Alves Silva & Bruno do Valle Pinheiro

  3. Laboratory of Respiration, Department of Internal Medicine, Universidade Federal do Ceará, Fortaleza, CE, Brazil

    Marcelo Alcantara Holanda

  4. Hospital Universitario de Getafe, Madrid, Spain

    José Ángel Lorente

  5. CIBER de Enfermedades Respiratorias, Madrid, Spain

    José Ángel Lorente

  6. Universidad Europea, Madrid, Spain

    José Ángel Lorente

Authors
  1. Aydra Mendes Almeida Bianchi
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  2. Maycon Moura Reboredo
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  3. Leda Marília Fonseca Lucinda
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  4. Fernando Fonseca Reis
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  5. Manfrinni Vinícius Alves Silva
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  6. Maria Aparecida Esteves Rabelo
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  7. Marcelo Alcantara Holanda
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  8. Júlio César Abreu Oliveira
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  9. José Ángel Lorente
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  10. Bruno do Valle Pinheiro
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Corresponding author

Correspondence to Bruno do Valle Pinheiro.

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Conflict of Interest

The authors declare that they have no conflicts of interest.

Ethical approval

All applicable international and national guidelines for the care and use of animals were followed. All procedures performed in studies involving animals were in accordance with the ethical standards of the institution or practice at which the studies were conducted. This study was approved by the Ethics Committee in Animal Experiments of Federal University of Juiz de Fora.

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Bianchi, A.M.A., Reboredo, M.M., Lucinda, L.M.F. et al. The Effects of Prone Position Ventilation on Experimental Mild Acute Lung Injury Induced by Intraperitoneal Lipopolysaccharide Injection in Rats. Lung 194, 193–199 (2016). https://doi.org/10.1007/s00408-016-9853-8

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  • DOI: https://doi.org/10.1007/s00408-016-9853-8

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