Hyaluronic acid plasma levels during high versus low tidal volume ventilation in a porcine sepsis model

PeerJ

article

Rainer Thomas¹  Tanghua Liu¹  Arno Schad²  Robert Ruemmler¹  Jens Kamuf¹  René Rissel¹  Thomas Ott¹  Matthias David¹  Erik K. Hartmann¹  Alexander Ziebart¹ 

[1] Department of Anesthesiology, Medical Centre of the Johannes Gutenberg University;Institute of Pathology, Medical Center of the Johannes Gutenberg-University

关键词: Hyaluronic acid;    Pig;    Sepsis;    Acute respiratory distress syndrome;    ARDS;    Lung protective ventilation;    Glycocalyx;    High tidal volume ventilation;   

DOI  :  10.7717/peerj.12649

学科分类：社会科学、人文和艺术（综合）

来源: Inra

【 摘 要 】

Background Shedding of the endothelial glycocalyx can be observed regularly during sepsis. Moreover, sepsis may be associated with acute respiratory distress syndrome (ARDS), which requires lung protective ventilation with the two cornerstones of application of low tidal volume and positive end-expiratory pressure. This study investigated the effect of a lung protective ventilation on the integrity of the endothelial glycocalyx in comparison to a high tidal volume ventilation mode in a porcine model of sepsis-induced ARDS. Methods After approval by the State and Institutional Animal Care Committee, 20 male pigs were anesthetized and received a continuous infusion of lipopolysaccharide to induce septic shock. The animals were randomly assigned to either low tidal volume ventilation, high tidal volume ventilation, or no-LPS-group groups and observed for 6 h. In addition to the gas exchange parameters and hematologic analyses, the serum hyaluronic acid concentrations were determined from central venous blood and from pre- and postpulmonary and pre- and postcerebral circulation. Post-mortem analysis included histopathological evaluation and determination of the pulmonary and cerebral wet-to-dry ratios. Results Both sepsis groups developed ARDS within 6 h of the experiment and showed significantly increased serum levels of hyaluronic acid in comparison to the no-LPS-group. No significant differences in the hyaluronic acid concentrations were detected before and after pulmonary and cerebral circulation. There was also no significant difference in the serum hyaluronic acid concentrations between the two sepsis groups. Post-mortem analysis showed no significant difference between the two sepsis groups. Conclusion In a porcine model of septic shock and ARDS, the serum hyaluronic acid levels were significantly elevated in both sepsis groups in comparison to the no-LPS-group. Intergroup comparison between lung protective ventilated and high tidal ventilated animals revealed no significant differences in the serum hyaluronic acid levels.

【 授权许可】

CC BY