Department of Anesthesia and Intensive Care, University Hospital Hradec Králové, Hradec Králové, Czech Republic.
Physiol Res. 2010;59(6):937-944. doi: 10.33549/physiolres.931877. Epub 2010 Jun 9.
Hypothermia was shown to attenuate ventilator-induced lung injury due to large tidal volumes. It is unclear if the protective effect of hypothermia is maintained under less injurious mechanical ventilation in animals without previous lung injury. Tracheostomized rats were randomly allocated to non-ventilated group (group C) or ventilated groups of normothermia (group N) and mild hypothermia (group H). After two hours of mechanical ventilation with inspiratory fraction of oxygen 1.0, respiratory rate 60 min(-1), tidal volume 10 ml x kg(-1), positive end-expiratory pressure (PEEP) 2 cm H2O or immediately after tracheostomy in non-ventilated animals inspiratory pressures were recorded, rats were sacrificed, pressure-volume (PV) curve of respiratory system constructed, bronchoalveolar lavage (BAL) fluid and aortic blood samples obtained. Group N animals exhibited a higher rise in peak inspiratory pressures in comparison to group H animals. Shift of the PV curve to right, higher total protein and interleukin-6 levels in BAL fluid were observed in normothermia animals in comparison with hypothermia animals and non-ventilated controls. Tumor necrosis factor-alpha was lower in the hypothermia group in comparison with normothermia and non-ventilated groups. Mild hypothermia attenuated changes in respiratory system mechanics and modified cytokine concentration in bronchoalveolar lavage fluid during low lung volume ventilation in animals without previous lung injury.
低温被证明可以减轻由于大潮气量引起的呼吸机相关性肺损伤。目前尚不清楚在没有先前肺损伤的动物中,低温对机械通气损伤较小的保护作用是否仍然存在。气管切开大鼠随机分为未通气组(C 组)或常温通气组(N 组)和轻度低温通气组(H 组)。在机械通气 2 小时后,吸入氧分数为 1.0,呼吸频率 60 次/分,潮气量 10ml/kg,呼气末正压(PEEP)2cmH2O,或在非通气动物中立即行气管切开后,记录吸气峰压,处死大鼠,构建呼吸系统压力-容积(PV)曲线,获取支气管肺泡灌洗液(BAL)和主动脉血样。与 H 组相比,N 组动物的吸气峰压升高更为明显。与低温组和非通气对照组相比,常温组动物的 PV 曲线右移,BAL 液中总蛋白和白细胞介素-6 水平升高。与常温组和非通气组相比,低温组肿瘤坏死因子-α水平较低。在没有先前肺损伤的动物中,轻度低温可减轻低肺容量通气时呼吸系统力学的变化,并调节支气管肺泡灌洗液中细胞因子的浓度。