Biologic Impact of Mechanical Power at High and Low Tidal Volumes in Experimental Mild Acute Respiratory Distress Syndrome

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorSANTOS, Raquel S.
dc.contributor.authorMAIA, Ligia de A.
dc.contributor.authorOLIVEIRA, Milena V.
dc.contributor.authorSANTOS, Cintia L.
dc.contributor.authorMORAES, Lillian
dc.contributor.authorPINTO, Eliete F.
dc.contributor.authorSAMARY, Cynthia dos S.
dc.contributor.authorMACHADO, Joana A.
dc.contributor.authorCARVALHO, Anna Carolinna
dc.contributor.authorFERNANDES, Marcos Vinicius de S.
dc.contributor.authorMARTINS, Vanessa
dc.contributor.authorCAPELOZZI, Vera L.
dc.contributor.authorMORALES, Marcelo M.
dc.contributor.authorKOCH, Thea
dc.contributor.authorABREU, Marcelo Gama de
dc.contributor.authorPELOSI, Paolo
dc.contributor.authorSILVA, Pedro L.
dc.contributor.authorROCCO, Patricia R. M.
dc.date.accessioned2018-09-13T15:26:33Z
dc.date.available2018-09-13T15:26:33Z
dc.date.issued2018
dc.description.abstractBackground: The authors hypothesized that low tidal volume (V-T) would minimize ventilator-induced lung injury regardless of the degree of mechanical power. The authors investigated the impact of power, obtained by different combinations of V-T and respiratory rate (RR), on ventilator-induced lung injury in experimental mild acute respiratory distress syndrome (ARDS). Methods: Forty Wistar rats received Escherichia coli lipopolysaccharide intratracheally. After 24h, 32 rats were randomly assigned to be mechanically ventilated (2 h) with a combination of different V-T (6 ml/kg and 11 ml/kg) and RR that resulted in low and high power. Power was calculated as energy (Delta P,(2)(L)/E,(L)) x RR (Delta P,(L) = transpulmonary driving pressure; E,(L) = lung elastance), and was three-fold higher in high than in low power groups. Eight rats were not mechanically ventilated and used for molecular biology analysis. Results: Diffuse alveolar damage score, which represents the severity of edema, atelectasis, and overdistension, was increased in high V-T compared to low V-T, in both low (low V-T: 11 [9 to 14], high V-T: 18 [15 to 20]) and high (low V-T: 19 [16 to 25], high V-T: 29 [27 to 30]) power groups. At high V-T, interleukin-6 and amphiregulin expressions were higher in high-power than in low-power groups. At high power, amphiregulin and club cell protein 16 expressions were higher in high V-T than in low V-T. Mechanical energy and power correlated well with diffuse alveolar damage score and interleukin-6, amphiregulin, and club cell protein 16 expression. Conclusions: In experimental mild ARDS, even at low V-T, high mechanical power promoted ventilator-induced lung injury. To minimize ventilator-induced lung injury, low V-T should be combined with low power.
dc.description.indexMEDLINE
dc.description.sponsorshipBrazilian Council for Scientific and Technological Development (CNPq
dc.description.sponsorshipBrasilia, Brazil)
dc.description.sponsorshipRio de Janeiro State Research Foundation (FAPERJ
dc.description.sponsorshipRio de Janeiro, Brazil)
dc.description.sponsorshipSao Paulo State Research Foundation (FAPESP
dc.description.sponsorshipSao Paolo, Brazil)
dc.description.sponsorshipNational Institute of Science and Technology for Regenerative Medicine (INCT-REGENERA
dc.description.sponsorshipRio de Janeiro, Brazil)
dc.description.sponsorshipCoordination for the Improvement of Higher Education Personnel (CAPES
dc.description.sponsorshipBrasilia, Brazil)
dc.identifier.citationANESTHESIOLOGY, v.128, n.6, p.1193-1206, 2018
dc.identifier.doi10.1097/ALN.0000000000002143
dc.identifier.eissn1528-1175
dc.identifier.issn0003-3022
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/28248
dc.language.isoeng
dc.publisherLIPPINCOTT WILLIAMS & WILKINS
dc.relation.ispartofAnesthesiology
dc.rightsrestrictedAccess
dc.rights.holderCopyright LIPPINCOTT WILLIAMS & WILKINS
dc.subject.otherinduced lung injury
dc.subject.otherend-expiratory pressure
dc.subject.otherdriving pressure
dc.subject.otherventilation
dc.subject.otherpulmonary
dc.subject.otherflow
dc.subject.otherinflammation
dc.subject.othermetaanalysis
dc.subject.otherhypercapnia
dc.subject.otherstrategies
dc.subject.wosAnesthesiology
dc.titleBiologic Impact of Mechanical Power at High and Low Tidal Volumes in Experimental Mild Acute Respiratory Distress Syndrome
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.affiliation.countryAlemanha
hcfmusp.affiliation.countryItália
hcfmusp.affiliation.countryisode
hcfmusp.affiliation.countryisoit
hcfmusp.author.externalSANTOS, Raquel S.:Univ Fed Rio de Janeiro, Carlos Chagas Filho Biophys Inst, Lab Pulm Invest, Rio De Janeiro, Brazil
hcfmusp.author.externalMAIA, Ligia de A.:Univ Fed Rio de Janeiro, Carlos Chagas Filho Biophys Inst, Lab Pulm Invest, Rio De Janeiro, Brazil
hcfmusp.author.externalOLIVEIRA, Milena V.:Univ Fed Rio de Janeiro, Carlos Chagas Filho Biophys Inst, Lab Pulm Invest, Rio De Janeiro, Brazil
hcfmusp.author.externalSANTOS, Cintia L.:Univ Fed Rio de Janeiro, Carlos Chagas Filho Biophys Inst, Lab Pulm Invest, Rio De Janeiro, Brazil
hcfmusp.author.externalMORAES, Lillian:Univ Fed Rio de Janeiro, Carlos Chagas Filho Biophys Inst, Lab Pulm Invest, Rio De Janeiro, Brazil
hcfmusp.author.externalPINTO, Eliete F.:Univ Fed Rio de Janeiro, Carlos Chagas Filho Biophys Inst, Lab Pulm Invest, Rio De Janeiro, Brazil
hcfmusp.author.externalSAMARY, Cynthia dos S.:Univ Fed Rio de Janeiro, Carlos Chagas Filho Biophys Inst, Lab Pulm Invest, Rio De Janeiro, Brazil
hcfmusp.author.externalMACHADO, Joana A.:Univ Fed Rio de Janeiro, Carlos Chagas Filho Biophys Inst, Lab Pulm Invest, Rio De Janeiro, Brazil
hcfmusp.author.externalCARVALHO, Anna Carolinna:Univ Fed Rio de Janeiro, Carlos Chagas Filho Biophys Inst, Lab Pulm Invest, Rio De Janeiro, Brazil
hcfmusp.author.externalFERNANDES, Marcos Vinicius de S.:Univ Fed Rio de Janeiro, Carlos Chagas Filho Biophys Inst, Lab Pulm Invest, Rio De Janeiro, Brazil
hcfmusp.author.externalMORALES, Marcelo M.:Univ Fed Rio de Janeiro, Carlos Chagas Filho Biophys Inst, Lab Cellular & Mol Physiol, Rio De Janeiro, Brazil
hcfmusp.author.externalKOCH, Thea:Tech Univ Dresden, Univ Hosp Carl Gustav Carus, Dept Anesthesiol & Intens Care Therapy, Pulm Engn Grp, Dresden, Germany
hcfmusp.author.externalABREU, Marcelo Gama de:Tech Univ Dresden, Univ Hosp Carl Gustav Carus, Dept Anesthesiol & Intens Care Therapy, Pulm Engn Grp, Dresden, Germany
hcfmusp.author.externalPELOSI, Paolo:Univ Genoa, Dept Surg Sci & Integrated Diagnost, San Martino Policlin Hosp, IRCCS Oncol, Genoa, Italy
hcfmusp.author.externalSILVA, Pedro L.:Univ Fed Rio de Janeiro, Carlos Chagas Filho Biophys Inst, Lab Pulm Invest, Rio De Janeiro, Brazil
hcfmusp.author.externalROCCO, Patricia R. M.:Univ Fed Rio de Janeiro, Carlos Chagas Filho Biophys Inst, Lab Pulm Invest, Rio De Janeiro, Brazil
hcfmusp.citation.scopus46
hcfmusp.contributor.author-fmusphcVANESSA MARTINS DA SILVA
hcfmusp.contributor.author-fmusphcVERA LUIZA CAPELOZZI
hcfmusp.description.beginpage1193
hcfmusp.description.endpage1206
hcfmusp.description.issue6
hcfmusp.description.volume128
hcfmusp.origemWOS
hcfmusp.origem.pubmed29489470
hcfmusp.origem.scopus2-s2.0-85045996078
hcfmusp.origem.wosWOS:000441172900019
hcfmusp.publisher.cityPHILADELPHIA
hcfmusp.publisher.countryUSA
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