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过氧但并非高潮量有助于健康小鼠的呼吸器引起的肺损伤
Yong Xu1,2, Yu Li3, Da Zhai1,2
1Department of Stem Cell Biology, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
BMC pulmonary medicine
|September 20, 2023
概括
机械通风期间严重的过氧会导致肺损伤. 带有中等氧气水平的高潮量通风可能不会诱导通风器诱导的肺损伤 (VILI).
科学领域:
- 肺部医学 肺部医学
- 关键护理医学 关键护理医学
- 实验生物学实验生物学
背景情况:
- 机械通风对于呼吸支至关重要,但会带来呼吸器诱导的肺损伤 (VILI) 的风险.
- 了解潮体积和氧气输送对VILI的独立和协同效应对于优化患者护理至关重要.
研究的目的:
- 调查潮体积和氧气度对VILI的独立和协同贡献.
- 为了确定高潮量通风在合理的正极呼气压 (PEEP) 时是否会导致肺损伤.
主要方法:
- 健康的雌性小鼠使用标准 (7毫升/公斤) 或高 (14毫升/公斤) 的潮体积进行机械通风2小时.
- 用室内空气进行通风,50%的O2 (中度过氧) 或100%的O2 (严重过氧) 在2cmH2O PEEP.
- 肺损伤通过测量肺湿干重量比和IL-1β和8-OHdG的水平来评估.
主要成果:
- 严重的过氧,无论潮体积如何,肺损伤标志物显著增加 (湿干比,IL-1β,8-OHdG).
- 适度的过氧,即使与高潮量,并没有显著提高IL-1β或8-OHdG水平.
- 在2cmH2OPEEP的高潮量通风没有显著诱导RhoA/ROCK通路的激活.
结论:
- 严重的高氧化是机械通风肺部炎症反应和氧化损伤的重要驱动因素.
- 高潮量通风在2cmH2O的PEEP可能不会导致VILI,建议采用保护性通风策略.
- 氧气度在VILI中起着至关重要的作用,在特定的PEEP条件下,可能比潮体积更重要.
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