Effects of frequency and inspiratory plateau pressure during recruitment manoeuvres on lung and distal organs in acute lung injury
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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).
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).
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.
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.
KeywordsAcute lung injury Sigh Ventilator-induced lung injury Transpulmonary pressure Apoptosis
We would like to express our gratitude to Mr. Andre Benedito da Silva for animal care, Mrs. Miriam Regina Taborda Simone and Ana Lucia Neves da Silva for their help with microscopy, Ms. Jaqueline Lima do Nascimento for her skilful technical assistance during the experiments, and Mrs. Moira Elizabeth Schöttler for assistance in editing the manuscript.
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