Recruitment Maneuver Does not Increase the Risk of Ventilator Induced Lung Injury
Background: Mechanical ventilation (MV) may induce lung injury. Aims: To assess and evaluate the role of different mechanical ventilation strategies on ventilator-induced lung injury (VILI) in comparison to a strategy which includes recruitment manoeuvre (RM). Study design: Randomized animal e...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Galenos Publishing House
2013-06-01
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| Series: | Balkan Medical Journal |
| Subjects: | |
| Online Access: | http://balkanmedicaljournal.org/text.php?lang=en&id=400 |
| _version_ | 1797911114674077696 |
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| author | İbrahim Özkan Akıncı Korkut Atalan Simru Tuğrul Perihan Ergin Özcan Ahmet Basel Lutfi Telci Nahit Çakar Dilek Yılmazbayhan Bayram Kıran |
| author_facet | İbrahim Özkan Akıncı Korkut Atalan Simru Tuğrul Perihan Ergin Özcan Ahmet Basel Lutfi Telci Nahit Çakar Dilek Yılmazbayhan Bayram Kıran |
| author_sort | İbrahim Özkan Akıncı |
| collection | DOAJ |
| description | Background: Mechanical ventilation (MV) may induce lung injury.
Aims: To assess and evaluate the role of different mechanical ventilation strategies on ventilator-induced lung injury (VILI) in comparison to a strategy which includes recruitment manoeuvre (RM).
Study design: Randomized animal experiment.
Methods: Thirty male Sprague-Dawley rats were anaesthetised, tracheostomised and divided into 5 groups randomly according to driving pressures; these were mechanically ventilated with following peak alveolar opening (Pao) and positive end-expiratory pressures (PEEP) for 1 hour: Group 15-0: 15 cmH2O Pao and 0 cmH2O PEEP; Group 30-10: 30 cmH2O Pao and 10 cmH2O PEEP; Group 30-5: 30 cmH2O Pao and 5 cmH2O PEEP; Group 30-5&RM: 30 cmH2O Pao and 5 cmH2O PEEP with additional 45 cmH2O CPAP for 30 seconds in every 15 minutes; Group 45-0: 45 cmH2O Pao and 0 cmH2O PEEP Before rats were sacrificed, blood samples were obtained for the evaluation of cytokine and chemokine levels; then, the lungs were subsequently processed for morphologic evaluation.
Results: Oxygenation results were similar in all groups; however, the groups were lined as follows according to the increasing severity of morphometric evaluation parameters: Group 15-0: (0±0.009) < Group 30-10: (0±0.14) < Group 30-5&RM: (1±0.12) < Group 30-5: (1±0.16) < Group 45-0: (2±0.16). Besides, inflammatory responses were the lowest in 30-5&RM group compared to all other groups. TNF-α, IL-1β, IL-6, MCP-1 levels were significantly different between group 30-5&RM and group 15-0 vs. group 45-0 in each group.
Conclusion: RM with low PEEP reduces the risk of ventilator-induced lung injury with a lower release of systemic inflammatory mediators in response to mechanical ventilation. |
| first_indexed | 2024-04-10T11:35:16Z |
| format | Article |
| id | doaj.art-5414696dd17342bba94ba4a16194b72a |
| institution | Directory Open Access Journal |
| issn | 2146-3123 2146-3131 |
| language | English |
| last_indexed | 2024-04-10T11:35:16Z |
| publishDate | 2013-06-01 |
| publisher | Galenos Publishing House |
| record_format | Article |
| series | Balkan Medical Journal |
| spelling | doaj.art-5414696dd17342bba94ba4a16194b72a2023-02-15T16:17:51ZengGalenos Publishing HouseBalkan Medical Journal2146-31232146-31312013-06-0130222923410.5152/balkanmedj.2013.7375Recruitment Maneuver Does not Increase the Risk of Ventilator Induced Lung Injuryİbrahim Özkan Akıncı0Korkut Atalan1Simru Tuğrul2Perihan Ergin Özcan3Ahmet Basel4Lutfi Telci5Nahit Çakar6Dilek Yılmazbayhan7Bayram Kıran8Department of Anaesthesiology and Intensive care, İstanbul University İstanbul Medical Faculty, İstanbul, TurkeyDepartment of Anaesthesiology and Intensive care, İstanbul University İstanbul Medical Faculty, İstanbul, TurkeyDepartment of Anaesthesiology and Intensive care, İstanbul University İstanbul Medical Faculty, İstanbul, TurkeyDepartment of Anaesthesiology and Intensive care, İstanbul University İstanbul Medical Faculty, İstanbul, TurkeyDepartment of Anaesthesiology and Intensive care, İstanbul University İstanbul Medical Faculty, İstanbul, TurkeyDepartment of Anaesthesiology and Intensive care, İstanbul University İstanbul Medical Faculty, İstanbul, TurkeyDepartment of Anaesthesiology and Intensive care, İstanbul University İstanbul Medical Faculty, İstanbul, TurkeyDepartment of Pathology, İstanbul University İstanbul Medical Faculty, İstanbul, TurkeyDepartment of Immunology, Experimental Medicine Research Institute, İstanbul University İstanbul Medical Faculty, İstanbul, TurkeyBackground: Mechanical ventilation (MV) may induce lung injury. Aims: To assess and evaluate the role of different mechanical ventilation strategies on ventilator-induced lung injury (VILI) in comparison to a strategy which includes recruitment manoeuvre (RM). Study design: Randomized animal experiment. Methods: Thirty male Sprague-Dawley rats were anaesthetised, tracheostomised and divided into 5 groups randomly according to driving pressures; these were mechanically ventilated with following peak alveolar opening (Pao) and positive end-expiratory pressures (PEEP) for 1 hour: Group 15-0: 15 cmH2O Pao and 0 cmH2O PEEP; Group 30-10: 30 cmH2O Pao and 10 cmH2O PEEP; Group 30-5: 30 cmH2O Pao and 5 cmH2O PEEP; Group 30-5&RM: 30 cmH2O Pao and 5 cmH2O PEEP with additional 45 cmH2O CPAP for 30 seconds in every 15 minutes; Group 45-0: 45 cmH2O Pao and 0 cmH2O PEEP Before rats were sacrificed, blood samples were obtained for the evaluation of cytokine and chemokine levels; then, the lungs were subsequently processed for morphologic evaluation. Results: Oxygenation results were similar in all groups; however, the groups were lined as follows according to the increasing severity of morphometric evaluation parameters: Group 15-0: (0±0.009) < Group 30-10: (0±0.14) < Group 30-5&RM: (1±0.12) < Group 30-5: (1±0.16) < Group 45-0: (2±0.16). Besides, inflammatory responses were the lowest in 30-5&RM group compared to all other groups. TNF-α, IL-1β, IL-6, MCP-1 levels were significantly different between group 30-5&RM and group 15-0 vs. group 45-0 in each group. Conclusion: RM with low PEEP reduces the risk of ventilator-induced lung injury with a lower release of systemic inflammatory mediators in response to mechanical ventilation.http://balkanmedicaljournal.org/text.php?lang=en&id=400ventilator-induced lung injuryTNF-αIL-1βIL-6Recruitment manoeuvreMCP-1 |
| spellingShingle | İbrahim Özkan Akıncı Korkut Atalan Simru Tuğrul Perihan Ergin Özcan Ahmet Basel Lutfi Telci Nahit Çakar Dilek Yılmazbayhan Bayram Kıran Recruitment Maneuver Does not Increase the Risk of Ventilator Induced Lung Injury Balkan Medical Journal ventilator-induced lung injury TNF-α IL-1β IL-6 Recruitment manoeuvre MCP-1 |
| title | Recruitment Maneuver Does not Increase the Risk of Ventilator Induced Lung Injury |
| title_full | Recruitment Maneuver Does not Increase the Risk of Ventilator Induced Lung Injury |
| title_fullStr | Recruitment Maneuver Does not Increase the Risk of Ventilator Induced Lung Injury |
| title_full_unstemmed | Recruitment Maneuver Does not Increase the Risk of Ventilator Induced Lung Injury |
| title_short | Recruitment Maneuver Does not Increase the Risk of Ventilator Induced Lung Injury |
| title_sort | recruitment maneuver does not increase the risk of ventilator induced lung injury |
| topic | ventilator-induced lung injury TNF-α IL-1β IL-6 Recruitment manoeuvre MCP-1 |
| url | http://balkanmedicaljournal.org/text.php?lang=en&id=400 |
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