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轻度低温可减轻油酸诱导的犬急性呼吸窘迫综合征的肾损伤。

Mild hypothermia attenuate kidney injury in canines with oleic acid-induced acute respiratory distress syndrome.

作者信息

Xia Jingen, Li Ran, Yang Rui, Zhang Li, Sun Bing, Feng Yingying, Jin Jingjing, Huang Linna, Zhan Qingyuan

机构信息

Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, PR China.

Beijing Institute of Respiratory Medicine, Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China.

出版信息

Injury. 2016 Jul;47(7):1445-51. doi: 10.1016/j.injury.2016.04.022. Epub 2016 May 3.

Abstract

BACKGROUND

Hypothermia may attenuate ventilator induced-lung injury in acute respiratory distress syndrome (ARDS). However, the impact of hypothermia on extra-pulmonary organ injury in ARDS remains unclear. The purpose of this study was to investigate whether hypothermia affects extra-pulmonary organ injury in a canine ARDS model induced by oleic acid.

OBJECTIVES

Twelve anesthetized canines with oleic acid-induced ARDS were randomly divided (n=6 per group) into a hypothermia group (core temperature of 33±1°C, HT group) and a normothermia group (core temperature of 38±1°C, NT group) and treated for four hours. The liver, small intestine and kidney were assessed by evaluating biochemical parameters, plasma and tissue cytokine levels, and tissue histopathological injury scores.

RESULTS

The HT group showed a lower plateau pressure, lung elastance and pulmonary vascular resistance. Hypothermia was associated with lower oxygen consumption (138.4±55.0mlmin(-1)vs. 72.0±11.2mlmin(-1), P<0.05) and higher oxygen saturation of mixed venous blood (62.8%±8.0% vs. 77.5%±10.1%, P<0.05). Both groups had similar levels of tumour necrosis factor-α in the plasma and extra-pulmonary organ, however, plasma interleukin-10 (97.1±25.0pgml(-1)vs. 131.4±27.0pgml(-1), P<0.05) was higher in the HT group. Further, the animals in the HT group had a lower levels of plasma creatinine (54.6±19.1UL(-1)vs. 29.1±8.0UL(-1), P<0.05), and lower renal histopathological injury scores [4.0(3.5;7.0) vs. 1.5(0.8;3.0), P<0.05]. Hypothermia did not affect the histopathological injury of the liver and small intestine.

CONCLUSIONS

Short-term mild hypothermia can reduce lung elastance and pulmonary vascular resistance, increase the systemic anti-inflammatory response and attenuate kidney histopathological injury in a canine ARDS model induced by oleic acid.

摘要

背景

低温可能减轻急性呼吸窘迫综合征(ARDS)中呼吸机诱导的肺损伤。然而,低温对ARDS肺外器官损伤的影响仍不清楚。本研究的目的是调查低温是否会影响油酸诱导的犬ARDS模型中的肺外器官损伤。

目的

将12只油酸诱导ARDS的麻醉犬随机分为两组(每组n = 6):低温组(核心温度33±1°C,HT组)和正常体温组(核心温度38±1°C,NT组),并治疗4小时。通过评估生化参数、血浆和组织细胞因子水平以及组织组织病理学损伤评分来评估肝脏、小肠和肾脏。

结果

HT组的平台压、肺弹性和肺血管阻力较低。低温与较低的氧耗量(138.4±55.0mlmin⁻¹对72.0±11.2mlmin⁻¹,P<0.05)和较高的混合静脉血氧饱和度(62.8%±8.0%对77.5%±10.1%,P<0.05)相关。两组血浆和肺外器官中的肿瘤坏死因子-α水平相似,然而,HT组的血浆白细胞介素-10水平更高(97.1±25.0pgml⁻¹对131.4±2⁷.0pgml⁻¹,P<0.05)。此外,HT组动物的血浆肌酐水平较低(54.6±19.1UL⁻¹对29.1±8.0UL⁻¹,P<0.05),肾脏组织病理学损伤评分也较低[4.0(3.5;7.0)对1.5(0.8;3.0),P<0.05]。低温不影响肝脏和小肠的组织病理学损伤。

结论

在油酸诱导的犬ARDS模型中,短期轻度低温可降低肺弹性和肺血管阻力,增强全身抗炎反应并减轻肾脏组织病理学损伤。

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