在机械通风过程中对隔膜中的蛋白质溶解通路的差调节
Aurélie Campeanu1, Myriam Lamamri2, Jules Loeb2
1Sorbonne Université, GRC 29, Groupe de Recherche Clinique en Anesthésie Réanimation médecine Périopératoire, F-75012, Paris, France; Assistance Publique - Hôpitaux de Paris (APHP), Hôpital La Pitié-Salpêtrière, Department of Anesthesiology and Critical Care, Paris, France; Sorbonne Université, INSERM, Centre de Recherche en Myologie, F-75013, Paris, France.
机械通风降低了腹膜中缩路径的调节,与其他肌肉不同. 这表明呼吸机诱导的隔膜功能障碍和重症监护室获得的弱点有不同的机制.
科学领域:
- 关键护理医学 关键护理医学
- 肌肉生理学 肌肉生理学
- 分子生物学分子生物学
背景情况:
- 在危急疾病中,机械通风 (MV) 会导致肌肉蛋白质溶解和减少蛋白质合成.
- 这可能导致呼吸机诱导的隔膜功能障碍 (VIDD) 和重症监护室获得的弱点 (ICU-AW).
- VIDD与长时间的MV和因通风而导致的断奶困难有关.
研究的目的:
- 在MV期间调查隔膜和其他骨肌肉之间的差分分子调制.
- 为了比较MV对隔膜肌肉与腹肌肌肉通路的影响.
主要方法:
- 来自14名脑死亡的捐赠者的隔膜和直腹肌活检,在MV上进行了≥24小时.
- 组织学分析,RNA测序,并通过RT-qPCR和西方涂抹途径的探索.
主要成果:
- 与直肠腹部相比,膜中的蛋白质和肌源性通路受到下调.
- 在隔膜中,炎症和细胞外基质通路被上调.
- 在隔膜中观察到FOXO1,Murf1和GSk3b的较低转录;CXCR-pi3k-akt通路上调.
- 隔膜肌纤维显示出比直肠腹部更大的横截面积.
结论:
- 在机械通风脑死亡捐赠者的腹膜中,缩性肌肉通路受到下调.
- 这些发现挑战了MV在严重疾病中对隔膜肌肉的假定影响.
- 结果表明VIDD和ICU-AW的病理生理机制不同.
相关概念视频
Mechanism of Breathing III: The Accessory Muscles
The respiratory system is a complex network that relies on primary respiratory muscles like the diaphragm, but also involves accessory muscles to enhance lung expansion and airflow during both inhalation and exhalation.
Enhancing Inhalation with Accessory Muscles:
Accessory muscles such as the sternocleidomastoid, scalene, intercostal, and abdominal muscles are crucial when additional respiratory effort is required, such as during deep...
Physiology of Respiration II: Neurogenic Control of Respiration
Central Control
The brainstem is the primary site of central control, hosting respiratory centers:
Physiological Control of Respiration
Breathing, a seemingly passive process, is regulated by the respiratory center in the brainstem. This center coordinates the involuntary control of respirations, which means it occurs without conscious effort, ensuring a smooth and uninterrupted pattern.
Regulation of Ventilation
The body maintains ventilation by monitoring levels of carbon dioxide (CO2), oxygen (O2), and hydrogen ion concentration (pH) in the arterial blood. Among these factors, the level of CO2 plays a crucial...
Ventilatory Modes
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
Mechanical Ventilation I: Indication and Settings
Respiratory Regulation of Acid-Base Balance
When carbon dioxide levels increase in the blood, more H+ and HCO3⁻ are...


