谷氨酰胺在呼吸机诱导的肺损伤大鼠模型中的保护作用。
The protective effects of glutamine in a rat model of ventilator-induced lung injury.
作者信息
Chen Chin-Ming, Cheng Kuo-Chen, Li Chien-Feng, Zhang Haibo
机构信息
1 Department of Recreation and Healthcare Management, Chia Nan University of Pharmacy & Science, Tainan, Taiwan ; 2 Department of Critical Care Medicine, Chi-Mei Medical Center and Chang Jung Christian University, Tainan, Taiwan ; 3 Section of Respiratory Care, Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan ; 4 Department of Safety Health and Environment Engineering, Chung Hwa University of Medical Technology, Tainan, Taiwan ; 5 Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan ; 6 Keenan Research Center for Biomedical Science of St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
出版信息
J Thorac Dis. 2014 Dec;6(12):1704-13. doi: 10.3978/j.issn.2072-1439.2014.11.06.
BACKGROUND
The mortality rate of patients with acute respiratory distress syndrome (ARDS) is still high despite the use of protective ventilatory strategies. We sought to examine the pharmacological effects of glutamine (GLN) in a two-hit model of endotoxin-induced inflammation followed by ventilator-induced lung injury (VILI). We hypothesized that the administration of GLN ameliorates the VILI.
METHODS
Sprague-Dawley rats were anesthetized and given lipopolysaccharide (LPS) intratracheally as a first hit to induce lung inflammation, followed 24 h later by a second hit of mechanical ventilation (MV) with either low tidal volume (6 mL/kg) with 5 cmH2O of positive end-expiratory pressure (PEEP) or high tidal volume (22 mL/kg) with zero PEEP for 4 h. GLN or lactated Ringer's solution as the placebo was administered intravenously 15 min prior to MV.
RESULTS
In the LPS-challenged rats ventilated with high tidal volume, the treatment with GLN improved lung injury indices, lung mechanics and cytokine responses compared with the placebo group.
CONCLUSIONS
The administration of GLN given immediately prior to MV may be beneficial in the context of reducing VILI.
背景
尽管采用了保护性通气策略，但急性呼吸窘迫综合征（ARDS）患者的死亡率仍然很高。我们试图研究谷氨酰胺（GLN）在内毒素诱导的炎症继发呼吸机诱导性肺损伤（VILI）的双打击模型中的药理作用。我们假设给予GLN可改善VILI。
方法
将Sprague-Dawley大鼠麻醉，经气管内给予脂多糖（LPS）作为第一次打击以诱导肺部炎症，24小时后进行第二次打击，采用低潮气量（6 mL/kg）加5 cmH2O呼气末正压（PEEP）或高潮气量（22 mL/kg）加零PEEP进行机械通气（MV）4小时。在MV前15分钟静脉注射GLN或乳酸林格液作为安慰剂。
结果
在接受高潮气量通气的LPS攻击大鼠中，与安慰剂组相比，GLN治疗改善了肺损伤指标、肺力学和细胞因子反应。
结论
在MV前立即给予GLN可能有助于减轻VILI。
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