Susceptibility to ventilator induced lung injury is increased in senescent rats

Critical Care

Torsten Schreiber³  Konrad Schwarzkopf²  Barbara Schmidt¹  Lars Hueter³  Karsten Oschatz³  Florian Setzer¹ 

[1] Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Erlanger Allee 101, 07747 Jena, Germany;Department of Anesthesia and Intensive Care, Klinikum Saarbrücken, Winterberg 1, 66119 Saarbrücken, Germany;Department of Anesthesia and Intensive Care, Zentralklinik Bad Berka, Robert-Koch-Allee 9, 99437 Bad Berka, Germany

关键词: lung lavage;    cytokines;    inflammation;    volutrauma;    tidal volume;    mechanical ventilation;    age;    ventilator-induced lung injury;   

Others  :  818134
DOI  :  10.1186/cc12744

 received in 2012-11-22, accepted in 2013-05-27,  发布年份 2013

【 摘 要 】

Introduction

The principal mechanisms of ventilator induced lung injury (VILI) have been investigated in numerous animal studies. However, prospective data on the effect of old age on VILI are limited. Under the hypothesis that susceptibility to VILI is increased in old age, we investigated the pulmonary and extrapulmonary effects of mechanical ventilation with high tidal volume (VT) in old compared to young adult animals.

Interventions

Old (19.1 ± 3.0 months) and young adult (4.4 ± 1.3 months) male Wistar rats were anesthetized and mechanically ventilated (positive end-expiratory pressure 5 cmH2O, fraction of inspired oxygen 0.4, respiratory rate 40/minute) with a tidal volume (VT) of either 8, 16 or 24 ml/kg for four hours.

Respiratory and hemodynamic variables, including cardiac output, and markers of systemic inflammation were recorded throughout the ventilation period. Lung histology and wet-to-dry weight ratio, injury markers in lung lavage and respiratory system pressure-volume curves were assessed post mortem. Basic pulmonary characteristics were assessed in non-ventilated animals.

Results

Compared to young adult animals, high VT (24 ml/kg body weight) caused more lung injury in old animals as indicated by decreased oxygenation (arterial oxygen tension (PaO2): 208 ± 3 vs. 131 ± 20 mmHg; P <0.05), increased lung wet-to-dry-weight ratio (5.61 ± 0.29 vs. 7.52 ± 0.27; P <0.05), lung lavage protein (206 ± 52 mg/l vs. 1,432 ± 101; P <0.05) and cytokine (IL-6: 856 ± 448 vs. 3,283 ± 943 pg/ml; P <0.05) concentration. In addition, old animals ventilated with high VT had more systemic inflammation than young animals (IL-1β: 149 ± 44 vs. 272 ± 36 pg/ml; P <0.05 - young vs. old, respectively).

Conclusions

Ventilation with unphysiologically large tidal volumes is associated with more lung injury in old compared to young rats. Aggravated pulmonary and systemic inflammation is a key finding in old animals developing VILI.

【 授权许可】

   
2013 Setzer et al.; licensee BioMed Central Ltd.

【 图 表 】

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