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Mechanical ventilation strategies alter cardiovascular biomarkers in an infant rat model

Philipp Baumann1,2, Susanne Wiegert1,2,3, Francesco Greco1,2,3

  • 1Department of Intensive Care Medicine and Neonatology, University Children's Hospital of Zurich, Zurich, Switzerland.

Physiological Reports
|January 31, 2018
PubMed

Insights

Mechanical ventilation impacts infant cardiovascular biomarkers. Positive end-expiratory pressure (PEEP) affected B-type natriuretic peptide (BNP), while vascular endothelial growth factor (VEGF) responded to various ventilation strategies, indicating potential for monitoring lung injury.

Area of Science:

  • Pediatric Critical Care Medicine
  • Cardiovascular Physiology
  • Respiratory Physiology

Background:

  • Mechanical ventilation (MV) is essential in pediatric critical care but can impact cardiovascular function.
  • Cardiovascular biomarkers are crucial for assessing patient status and guiding treatment.
  • The effects of specific MV strategies on infant cardiovascular biomarkers are not well understood.

Purpose of the Study:

  • To investigate the impact of different mechanical ventilation strategies on key cardiovascular biomarkers in infant rats.
  • To determine if biomarkers like BNP, VEGF, and ET-1 change in response to varying positive end-expiratory pressure (PEEP), oxygen levels, and CO2 levels.
  • To explore the potential of these biomarkers as indicators of ventilation-induced cardiovascular compromise and lung injury.

Main Methods:

  • A retrospective study using a validated in vivo infant rat model (14-day-old Wistar rats).
  • Rats were subjected to 2 hours of mechanical ventilation with controlled variations in PEEP (high and low), hyperoxemia, hypoxemia, hypercapnia, and hypocapnia.
  • Plasma concentrations of B-type natriuretic peptide (BNP), vascular endothelial growth factor (VEGF), and endothelin-1 (ET-1) were measured and compared to control groups.

Main Results:

  • B-type natriuretic peptide (BNP) levels were significantly altered by both high (9 cmH2O) and low (1 cmH2O) PEEP.
  • Vascular endothelial growth factor (VEGF) concentrations were associated with high PEEP, hyperoxemia, hypoxemia, and hypocapnia.
  • Endothelin-1 (ET-1) levels showed a significant change specifically in response to hypoxemia.

Conclusions:

  • The specific strategy of mechanical ventilation significantly influences plasma biomarker concentrations in infants.
  • BNP and VEGF may serve as valuable surrogate markers for detecting ventilation-induced cardiovascular compromise and lung tissue damage.
  • Sudden hyperoxemia may rapidly induce VEGF release, potentially as a protective cellular response.

Keywords:
Biomarkerhyperoxiahypoxiapositive end-expiratory pressure

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