Department of Intensive Care, RWTH University Hospital, Germany.
Respir Physiol Neurobiol. 2011 Dec 15;179(2-3):174-80. doi: 10.1016/j.resp.2011.08.003. Epub 2011 Aug 7.
We examined the influences of acute lung injury and hypoxia on neurological outcome. Functional performance was assessed using a neurocognitive test and a neurologic deficit score (NDS) five days before. On experimental day, mechanically ventilated pigs were randomized to hypoxia only (HO group, n=5) or to acute lung injury (ALI group, n=5). Hemodynamics, respiratory mechanics, systemic cytokines and further physiologic variables were obtained at baseline, at the time of ALI, 2, 4 and 8h thereafter. Subsequently, injured lungs were recruited and animals weaned from the ventilator. Neurocognitive testing was re-examined for five days. Then, brains were harvested for neurohistopathology. After the experiment, neurocognitive performance was significantly worsened and the NDS increased in the ALI group. Histopathology revealed no significant differences. Oxygenation was comparable between groups although significantly higher inspiratory pressures occured after ALI. Cytokines showed a trend towards higher levels after ALI. Neurocognitive compromise after ALI seems due to a more pronounced inflammatory response and complex mechanical ventilation.
我们研究了急性肺损伤和低氧血症对神经功能预后的影响。在实验前五天，使用神经认知测试和神经缺陷评分（NDS）评估功能表现。在实验当天，机械通气的猪被随机分为单纯低氧组（HO 组，n=5）或急性肺损伤组（ALI 组，n=5）。在基线、ALI 时、2、4 和 8 小时后，分别获得血流动力学、呼吸力学、全身细胞因子和其他生理变量。随后，对受损的肺进行复张并使动物脱离呼吸机。对神经认知功能进行了五天的重新测试。然后，收获大脑进行神经组织病理学检查。实验结束后，ALI 组的神经认知表现明显恶化，NDS 增加。组织病理学检查未见明显差异。尽管 ALI 后吸气压力明显升高，但两组的氧合情况相当。细胞因子在 ALI 后呈升高趋势。ALI 后出现的神经认知功能障碍可能是由于更明显的炎症反应和复杂的机械通气所致。
