Intensive Care Medicine

, Volume 35, Issue 6, pp 1120–1128 | Cite as

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

  • Paula W. Steimback
  • Gisele P. Oliveira
  • Andréia F. Rzezinski
  • Pedro L. Silva
  • Cristiane S. N. B. Garcia
  • Graziela Rangel
  • Marcelo M. Morales
  • José R. Lapa e Silva
  • Vera L. Capelozzi
  • Paolo Pelosi
  • Patricia R. M. Rocco
Experimental

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 injury Sigh Ventilator-induced lung injury Transpulmonary pressure Apoptosis 

Notes

Acknowledgments

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.

Supplementary material

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

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Paula W. Steimback
    • 1
  • Gisele P. Oliveira
    • 1
  • Andréia F. Rzezinski
    • 1
  • Pedro L. Silva
    • 1
  • Cristiane S. N. B. Garcia
    • 1
  • Graziela Rangel
    • 2
  • Marcelo M. Morales
    • 2
  • José R. Lapa e Silva
    • 3
  • Vera L. Capelozzi
    • 4
  • Paolo Pelosi
    • 5
  • Patricia R. M. Rocco
    • 1
  1. 1.Laboratory of Pulmonary Investigation, Instituto de Biofísica Carlos Chagas Filho, C.C.S.Universidade Federal do Rio de JaneiroRio de JaneiroBrazil
  2. 2.Laboratory of Cellular and Molecular Physiology, Carlos Chagas Filho Institute of BiophysicsRio de JaneiroBrazil
  3. 3.Department of PneumologyFederal University of Rio de JaneiroRio de JaneiroBrazil
  4. 4.Department of PathologyUniversity of São PauloSão PauloBrazil
  5. 5.Department of Ambient, Health and SafetyUniversity of InsubriaVareseItaly

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