Division of Pathophysiology of Inflammation, Research Center Borstel, Borstel, Germany.
BMC Pulm Med. 2010 Apr 21;10:21. doi: 10.1186/1471-2466-10-21.
A large number of studies have investigated the effects of high tidal volume ventilation in mouse models. In contrast data on very short term effects of low tidal volume ventilation are sparse. Therefore we investigated the functional and structural effects of low tidal volume ventilation in mice.
38 Male C57/Bl6 mice were ventilated with different tidal volumes (Vt 5, 7, and 10 ml/kg) without or with application of PEEP (2 cm H2O). Four spontaneously breathing animals served as controls. Oxygen saturation and pulse rate were monitored. Lung function was measured every 5 min for at least 30 min. Afterwards lungs were removed and histological sections were stained for measurement of infiltration with polymorphonuclear leukocytes (PMN). Moreover, mRNA expression of macrophage inflammatory protein (MIP)-2 and tumor necrosis factor (TNF)alpha in the lungs was quantified using real time PCR.
Oxygen saturation did not change significantly over time of ventilation in all groups (P > 0.05). Pulse rate dropped in all groups without PEEP during mechanical ventilation. In contrast, in the groups with PEEP pulse rate increased over time. These effects were not statistically significant (P > 0.05). Tissue damping (G) and tissue elastance (H) were significantly increased in all groups after 30 min of ventilation (P < 0.05). Only the group with a Vt of 10 ml/kg and PEEP did not show a significant increase in H (P > 0.05). Mechanical ventilation significantly increased infiltration of the lungs with PMN (P < 0.05). Expression of MIP-2 was significantly induced by mechanical ventilation in all groups (P < 0.05). MIP-2 mRNA expression was lowest in the group with a Vt of 10 ml/kg + PEEP.
Our data show that very short term mechanical ventilation with lower tidal volumes than 10 ml/kg did not reduce inflammation additionally. Formation of atelectasis and inadequate oxygenation with very low tidal volumes may be important factors. Application of PEEP attenuated inflammation.
大量研究已经调查了高潮气量通气在小鼠模型中的影响。相比之下,关于低潮气量通气的短期影响的数据却很少。因此,我们研究了低潮气量通气对小鼠的功能和结构影响。
38 只雄性 C57/Bl6 小鼠接受不同潮气量(5、7 和 10 ml/kg)的通气,或同时应用呼气末正压通气(PEEP,2 cm H2O)。4 只自主呼吸的动物作为对照。监测血氧饱和度和脉搏率。至少 30 分钟内每 5 分钟测量一次肺功能。之后取出肺,对多形核白细胞(PMN)浸润进行染色,测量组织切片。此外,使用实时 PCR 定量测量肺中巨噬细胞炎症蛋白(MIP)-2 和肿瘤坏死因子(TNF)alpha 的 mRNA 表达。
所有组的通气过程中血氧饱和度随时间的变化均无显著差异(P > 0.05)。无 PEEP 的所有组在机械通气期间脉搏率下降。相比之下,有 PEEP 的组脉搏率随时间增加。这些影响没有统计学意义(P > 0.05)。通气 30 分钟后,所有组的组织阻尼(G)和组织弹性(H)均显著增加(P < 0.05)。只有潮气量为 10 ml/kg 且有 PEEP 的组 H 无显著增加(P > 0.05)。机械通气显著增加了肺 PMN 的浸润(P < 0.05)。所有组的 MIP-2 表达均因机械通气而显著诱导(P < 0.05)。潮气量为 10 ml/kg + PEEP 的组中 MIP-2 mRNA 表达最低。
我们的数据表明,与 10 ml/kg 以下的潮气量相比,短期机械通气不会额外减轻炎症。形成的肺不张和非常低的潮气量导致的氧合不足可能是重要因素。PEEP 的应用减轻了炎症。