Intensive Care Medicine

, 34:763

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

  • Nicolas de Prost
  • Didier Dreyfuss
  • Jean-Damien Ricard
  • Georges Saumon
Experimental

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 

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Nicolas de Prost
    • 1
    • 2
  • Didier Dreyfuss
    • 2
    • 3
  • Jean-Damien Ricard
    • 2
    • 3
    • 4
  • Georges Saumon
    • 1
    • 2
  1. 1.INSERM U773, Equipe 11Centre de Recherche Bichat Beaujon CRB3ParisFrance
  2. 2.Site Xavier BichatUniversité Paris 7 Denis DiderotParisFrance
  3. 3.Assistance Publique – Hôpitaux de Paris, Service de Réanimation MédicaleHôpital Louis MourierColombesFrance
  4. 4.INSERM U722ParisFrance

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