Mei Binbin, Cui Feifei, Wu Chao, Wen Zunjia, Wang Wenting, Shen Meifen
a Institute of Nursing, Zhejiang Chinese Medical University , Hangzhou , China.
b Department of Intensive Care Unit , the First Affiliated Hospital of Soochow University , Suzhou , China.
Exp Lung Res. 2018 Dec;44(10):433-442. doi: 10.1080/01902148.2018.1516832. Epub 2019 Apr 11.
Tracheostomy usually accompanied by the impairment of cough reflex, which may affect the clearance of secretions and result in the occurrence and development of pulmonary inflammation. Previous research has demonstrated that citric acid could effectively evoke cough. However, there are limited data available on this topic specific to the cough stimulation method, and the roles of citric acid in tracheostomy still remain obscure. The aims of present study were to identify the potential roles of citric acid in conjunction with saline nebulization in tracheostomy in guinea pigs.
Experimental tracheostomy model was induced in guinea pigs, and different nebulization interventions were implemented. The expression of P-selectin and platelet count were analyzed by flow cytometer and automatic globulimeter, the histological changes in trachea and lung tissue were assessed by hematoxylin and eosin staining, and the inflammatory cytokines and substance P (SP) levels in bronchoalveolar lavage fluid were evaluated by enzyme-linked immunosorbent assay.
Tracheostomy resulted in the disorder of trachea mucosa and cilia, the inflammatory cell infiltration in lung tissue, the increase of IL-6, TNF-α levels and the decrease of SP level. Citric acid alone increase the SP level, and the joint action of citric acid and saline nebulization further showed significantly beneficial effects on pathological, inflammatory changes and SP level.
Citric acid combined with saline nebulization contributes to the alleviation of tracheotomy-induced tracheal damage and pulmonary inflammation in an experimental tracheostomy model in guinea pigs. This may provide novel insights into the inflammation management and cough recovery after tracheostomy.
气管切开术通常伴随着咳嗽反射受损，这可能会影响分泌物的清除并导致肺部炎症的发生和发展。先前的研究表明，柠檬酸可有效诱发咳嗽。然而，关于这种特定咳嗽刺激方法的相关数据有限，且柠檬酸在气管切开术中的作用仍不明确。本研究的目的是确定柠檬酸联合盐水雾化在豚鼠气管切开术中的潜在作用。
在豚鼠中建立实验性气管切开术模型，并实施不同的雾化干预。通过流式细胞仪和自动血细胞分析仪分析P-选择素的表达和血小板计数，通过苏木精-伊红染色评估气管和肺组织的组织学变化，通过酶联免疫吸附测定法评估支气管肺泡灌洗液中的炎性细胞因子和P物质（SP）水平。
气管切开术导致气管黏膜和纤毛紊乱、肺组织炎性细胞浸润、IL-6和TNF-α水平升高以及SP水平降低。单独使用柠檬酸可提高SP水平，柠檬酸与盐水雾化的联合作用对病理、炎症变化和SP水平进一步显示出显著的有益效果。
在豚鼠实验性气管切开术模型中，柠檬酸联合盐水雾化有助于减轻气管切开术引起的气管损伤和肺部炎症。这可能为气管切开术后的炎症管理和咳嗽恢复提供新的见解。
