Gayan-Ramirez Ghislaine, de Paepe Kristel, Cadot Pascal, Decramer Marc
Respiratory Muscle Research Unit, Laboratory of Pneumology and Respiratory Rehabilitation and Respiratory Division, University Hospitals, Katholieke Universiteit Leuven, Herestraat 49, 3000 Leuven, Belgium.
Intensive Care Med. 2003 May;29(5):825-33. doi: 10.1007/s00134-003-1688-0. Epub 2003 Apr 8.
Because respiratory muscle weakness appears to play an important role in weaning from mechanical ventilation, we developed an animal model of mechanical ventilation with appropriate controls in order to determine whether 24 h of mechanical ventilation already affected diaphragmatic function.
Fifty-two male Wistar rats were randomized into three groups: a non-anesthetized control group (C, n=10), an anesthetized spontaneously breathing group (SB, n=9 out of 26), and an anesthetized and mechanically ventilated group (MV, n=12 out of 16).
After 24 h, in vitro diaphragmatic force was decreased in SB group but even more so in MV group (i.e., 80 Hz: -15% in SB, P<0.005 vs C and -34% in MV group, P<0.005 vs C and SB). This was associated with a significant decrease in the diaphragm type I and type IIa dimensions in the SB group, which was more pronounced in the MV group. Interestingly, diaphragm IGF-I mRNA was decreased in the SB group (-14%, P<0.05 vs C), but more so in MV group (-29%, P<0.001 vs C and P<0.01 vs SB). Moreover, there was a significant correlation between diaphragm force and IGF-I mRNA (at 80 Hz r=0.51, P=0.0056).
We conclude that 24 h of mechanical ventilation in rats, independently of anesthesia, already significantly reduced diaphragm force, fiber dimensions, and its IGF-I mRNA levels.
由于呼吸肌无力似乎在机械通气撤机过程中起重要作用,我们建立了一个带有适当对照的机械通气动物模型,以确定24小时的机械通气是否已经影响膈肌功能。
52只雄性Wistar大鼠被随机分为三组:非麻醉对照组(C组,n = 10)、麻醉自主呼吸组(SB组,26只中的9只)和麻醉机械通气组(MV组,16只中的12只)。
24小时后,SB组的体外膈肌力量下降,但MV组下降得更明显(即80赫兹时:SB组下降15%,与C组相比P<0.005;MV组下降34%,与C组和SB组相比P<0.005)。这与SB组膈肌I型和IIa型纤维尺寸的显著减小有关,在MV组中更为明显。有趣的是,SB组膈肌IGF-I mRNA水平下降(-14%,与C组相比P<0.05),但MV组下降得更多(-29%,与C组相比P<0.001,与SB组相比P<0.01)。此外,膈肌力量与IGF-I mRNA之间存在显著相关性(80赫兹时r = 0.51,P = 0.0056)。
我们得出结论,大鼠24小时的机械通气,与麻醉无关,已经显著降低了膈肌力量、纤维尺寸及其IGF-I mRNA水平。