Please use this identifier to cite or link to this item: https://observatorio.fm.usp.br/handle/OPI/23511
Title: The Effects of Low and High Tidal Volume and Pentoxifylline on Intestinal Blood Flow and Leukocyte-Endothelial Interactions in Mechanically Ventilated Rats
Authors: AIKAWA, PriscilaZHANG, HaiboBARBAS, Carmen S. V.PAZETTI, RogerioCORREIA, CristianoMAUAD, ThaisSILVA, EliezerSANNOMIYA, PaulinaPOLI-DE-FIGUEIREDO, Luiz F.NAKAGAWA, Naomi Kondo
Citation: RESPIRATORY CARE, v.56, n.12, p.1942-1949, 2011
Abstract: BACKGROUND: The combination of high PEEP and low tidal volume (V(T)) decreases some risks of mechanical ventilation, including pulmonary overdistention, damage due to cyclic opening and closing of the alveoli, and inflammatory responses that can lead to multiple-organ dysfunction. We hypothesized that high V(T) and high PEEP induce mesenteric microcirculatory disturbances and that those disturbances would be attenuated by pentoxifylline, which is anti-inflammatory. METHODS: We anesthetized (isoflurane 1.5%), tracheostomized, and mechanically ventilated 57 male Wistar rats with PEEP of 10 cm H(2)O and F(IO2) of 0.21 for 2 hours. One group received low V(T) (7 mL/kg), another group received high V(T) (10 mL/kg), and a third group received high V(T) plus pentoxifylline (25 mg/kg). We measured mean arterial pressure, respiratory mechanics, mesenteric blood flow, and leukocyte-endothelial interactions. RESULTS: The mean arterial pressure was similar among the groups at baseline (108 mm Hg [IQR 94-118 mm Hg]) and after 2 hours of mechanical ventilation (104 mm Hg [IQR 90-114 mm Hg]). Mesenteric blood flow was also similar between the groups: low V(T) 15.1 mL/min (IQR 12.4-17.7 mL/min), high V(T) 11.3 mL/min (IQR 8.6-13.8 mL/min), high-V(T)/pentoxifylline 12.4 mL/min (10.8-13.7 mL/min). Peak airway pressure after 2 hours was lower (P = .03) in the low-V(T) group (10.4 cm H(2)O [IQR 10.2-10.4 cm H(2)O]) than in the high-V(T) group (12.6 cm H(2)O [10.2-14.9 cm H(2)O]) or the high-V(T)/pentoxifylline group (12.8 cm H(2)O [10.7-16.0 cm H(2)O]). There were fewer adherent leukocytes (P = .005) and fewer migrated leukocytes (P = .002) in the low-V(T) group (5 cells/100 gm length [IQR 4-7 cells/100 mu m length] and 1 cell/5,000 mu m(2) [IQR 1-2 cells/5,000 mu m(2)], respectively) and the high-V(T)/pentoxifylline group (5 cells/100 mu m length [IQR 3-10 cells/100 mu m length] and 1 cell/5,000 mu m(2) [IQR 1-3 cells/5,000 mu m(2)], respectively) than in the high-V(T) group (14 cells/100 mu m length [IQR 11-16 cells/100 mu m length] and 9 cells/5,000 mu m(2) [IQR 8-12 cells/5,000 mu m(2)], respectively). CONCLUSIONS: Low V(T) with high PEEP was lung-protective, and early pentoxifylline reduced the inflammatory response to high V(T) with high PEEP (and presumed lung overdistention) during mechanical ventilation.
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Artigos e Materiais de Revistas Científicas - FM/MCG
Departamento de Cirurgia - FM/MCG

Artigos e Materiais de Revistas Científicas - FM/MFT
Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional - FM/MFT

Artigos e Materiais de Revistas Científicas - FM/MPT
Departamento de Patologia - FM/MPT

Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

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Instituto do Coração - HC/InCor

Artigos e Materiais de Revistas Científicas - LIM/05
LIM/05 - Laboratório de Poluição Atmosférica Experimental

Artigos e Materiais de Revistas Científicas - LIM/09
LIM/09 - Laboratório de Pneumologia

Artigos e Materiais de Revistas Científicas - LIM/11
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação

Artigos e Materiais de Revistas Científicas - LIM/34
LIM/34 - Laboratório de Ciências da Reabilitação

Artigos e Materiais de Revistas Científicas - LIM/61
LIM/61 - Laboratório de Pesquisa em Cirurgia Torácica


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