Ferreira Juliana Dias Nascimento, Reboredo Maycon Moura, Costa Eduardo Leite Vieira, Fonseca Lídia Maria Carneiro da, Retamal Jaime, Santos Fabrício Júnio Mendes, Paoli Flavia de, Fonseca Adenilson de Souza da, Lucinda Leda Marília Fonseca, Pinheiro Bruno Valle
. Divisão de Pneumologia e Terapia Intensiva, Hospital Universitário, Universidade Federal de Juiz de Fora, Juiz de Fora (MG), Brasil.
. Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora (MG), Brasil.
J Bras Pneumol. 2024 Dec 16;50(6):e20240269. doi: 10.36416/1806-3756/e20240269. eCollection 2024.
Here, we investigated the effects of hyperventilation on acute lung injury (ALI) in spontaneously breathing rats.
Wistar rats were randomized to receive either intraperitoneal lipopolysaccharides (LPS) or saline, and intravenous infusion of NH4Cl (to induce metabolic acidosis and hyperventilation) or saline. Four groups were established: control-control (C-C), control-hyperventilation (C-HV), LPS-control (LPS-C), and LPS-hyperventilation (LPS-HV). Venous blood gases were collected before and after NH4Cl infusion and analyzed to confirm the presence of metabolic acidosis and hyperventilation. After euthanasia, lung injury was assessed using the ALI score, morphometric quantification of perivascular edema, neutrophil counts in the bronchoalveolar lavage, and mRNA expression of biological markers in the lung tissue.
Hyperventilation induced inflammatory lung injury in previously healthy lungs and exacerbated injuries previously induced by LPS (ALI score: C-C=0.14 [IQR 0.12; 0.14]; C-HV=0.36 [IQR 0.31; 0.37]; LPS-C=0.51 [IQR 0.50; 0.54]; LPS-HV=0.58 [IQR 0.56; 0.62]; p<0.01). Perivascular edema, neutrophil counts in bronchoalveolar lavage, and amphiregulin mRNA expression were higher in the LPS-HV group compared to the control group.
Hyperventilation increased inflammatory injury in rats with ALI during spontaneous ventilation. These results suggest that the impact of vigorous spontaneous breathing efforts on worsening inflammatory lung injury warrants further investigation.
在此,我们研究了过度通气对自主呼吸大鼠急性肺损伤(ALI)的影响。
将Wistar大鼠随机分为腹腔注射脂多糖(LPS)组或生理盐水组,并静脉输注氯化铵(以诱导代谢性酸中毒和过度通气)或生理盐水。建立四组:对照-对照(C-C)、对照-过度通气(C-HV)、LPS-对照(LPS-C)和LPS-过度通气(LPS-HV)。在输注氯化铵前后采集静脉血气并进行分析,以确认代谢性酸中毒和过度通气的存在。安乐死后,使用ALI评分、血管周围水肿的形态计量学量化、支气管肺泡灌洗中的中性粒细胞计数以及肺组织中生物标志物的mRNA表达来评估肺损伤。
过度通气在先前健康的肺中诱导了炎症性肺损伤,并加剧了先前由LPS诱导的损伤(ALI评分:C-C = 0.14 [四分位间距0.12;0.14];C-HV = 0.36 [四分位间距0.31;0.37];LPS-C = 0.51 [四分位间距0.50;0.54];LPS-HV = 0.58 [四分位间距0.56;0.62];p<0.01)。与对照组相比,LPS-HV组的血管周围水肿、支气管肺泡灌洗中的中性粒细胞计数和双调蛋白mRNA表达更高。
在自主通气期间,过度通气增加了ALI大鼠的炎症性损伤。这些结果表明,剧烈的自主呼吸努力对炎症性肺损伤恶化的影响值得进一步研究。