LIZANDRE KEREN RAMOS DA SILVEIRA
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
1 resultados
Resultados de Busca
Agora exibindo 1 - 1 de 1
- Effects of different fluid management on lung and kidney during pressure-controlled and pressure-support ventilation in experimental acute lung injury(2022) CARVALHO, Eduardo Butturini de; FONSECA, Ana Carolina Fernandes; MAGALHAES, Raquel Ferreira; PINTO, Eliete Ferreira; SAMARY, Cynthia dos Santos; ANTUNES, Mariana Alves; BALDAVIRA, Camila Machado; SILVEIRA, Lizandre Keren Ramos da; TEODORO, Walcy Rosolia; ABREU, Marcelo Gama de; CAPELOZZI, Vera Luiza; FELIX, Nathane Santanna; PELOSI, Paolo; ROCCO, Patricia Rieken Macedo; SILVA, Pedro LemeOptimal fluid management is critical during mechanical ventilation to mitigate lung damage. Under normovolemia and protective ventilation, pulmonary tensile stress during pressure-support ventilation (PSV) results in comparable lung protection to compressive stress during pressure-controlled ventilation (PCV) in experimental acute lung injury (ALI). It is not yet known whether tensile stress can lead to comparable protection to compressive stress in ALI under a liberal fluid strategy (LF). A conservative fluid strategy (CF) was compared with LF during PSV and PCV on lungs and kidneys in an established model of ALI. Twenty-eight male Wistar rats received endotoxin intratracheally. After 24 h, they were treated with CF (minimum volume of Ringer's lactate to maintain normovolemia and mean arterial pressure >= 70 mmHg) or LF (similar to 4 times higher than CF) combined with PSV or PCV (VT = 6 ml/kg, PEEP = 3 cmH(2)O) for 1 h. Nonventilated animals (n = 4) were used for molecular biology analyses. CF-PSV compared with LF-PSV: (1) decreased the diffuse alveolar damage score (10 [7.8-12] vs. 25 [23-31.5], p = 0.006), mainly due to edema in axial and alveolar parenchyma; (2) increased birefringence for occludin and claudin-4 in lung tissue and expression of zonula-occludens-1 and metalloproteinase-9 in lung. LF compared with CF reduced neutrophil gelatinase-associated lipocalin and interleukin-6 expression in the kidneys in PSV and PCV. In conclusion, CF compared with LF combined with PSV yielded less lung epithelial cell damage in the current model of ALI. However, LF compared with CF resulted in less kidney injury markers, regardless of the ventilatory strategy.