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

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-expi...

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Main Authors: Rainer Thomas, Tanghua Liu, Arno Schad, Robert Ruemmler, Jens Kamuf, René Rissel, Thomas Ott, Matthias David, Erik K. Hartmann, Alexander Ziebart
Format: Article
Language:English
Published: PeerJ Inc. 2022-01-01
Series:PeerJ
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Online Access:https://peerj.com/articles/12649.pdf
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author Rainer Thomas
Tanghua Liu
Arno Schad
Robert Ruemmler
Jens Kamuf
René Rissel
Thomas Ott
Matthias David
Erik K. Hartmann
Alexander Ziebart
author_facet Rainer Thomas
Tanghua Liu
Arno Schad
Robert Ruemmler
Jens Kamuf
René Rissel
Thomas Ott
Matthias David
Erik K. Hartmann
Alexander Ziebart
author_sort Rainer Thomas
collection DOAJ
description 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.
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spelling doaj.art-66ec73ebec0a48d6a8d19cc5a26b10402023-12-02T21:37:43ZengPeerJ Inc.PeerJ2167-83592022-01-019e1264910.7717/peerj.12649Hyaluronic acid plasma levels during high versus low tidal volume ventilation in a porcine sepsis modelRainer Thomas0Tanghua Liu1Arno Schad2Robert Ruemmler3Jens Kamuf4René Rissel5Thomas Ott6Matthias David7Erik K. Hartmann8Alexander Ziebart9Department of Anesthesiology, Medical Centre of the Johannes Gutenberg University, Mainz, GermanyDepartment of Anesthesiology, Medical Centre of the Johannes Gutenberg University, Mainz, GermanyInstitute of Pathology, Medical Center of the Johannes Gutenberg-University, Mainz, GermanyDepartment of Anesthesiology, Medical Centre of the Johannes Gutenberg University, Mainz, GermanyDepartment of Anesthesiology, Medical Centre of the Johannes Gutenberg University, Mainz, GermanyDepartment of Anesthesiology, Medical Centre of the Johannes Gutenberg University, Mainz, GermanyDepartment of Anesthesiology, Medical Centre of the Johannes Gutenberg University, Mainz, GermanyDepartment of Anesthesiology, Medical Centre of the Johannes Gutenberg University, Mainz, GermanyDepartment of Anesthesiology, Medical Centre of the Johannes Gutenberg University, Mainz, GermanyDepartment of Anesthesiology, Medical Centre of the Johannes Gutenberg University, Mainz, GermanyBackground 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.https://peerj.com/articles/12649.pdfHyaluronic acidPigSepsisAcute respiratory distress syndromeARDSLung protective ventilation
spellingShingle Rainer Thomas
Tanghua Liu
Arno Schad
Robert Ruemmler
Jens Kamuf
René Rissel
Thomas Ott
Matthias David
Erik K. Hartmann
Alexander Ziebart
Hyaluronic acid plasma levels during high versus low tidal volume ventilation in a porcine sepsis model
PeerJ
Hyaluronic acid
Pig
Sepsis
Acute respiratory distress syndrome
ARDS
Lung protective ventilation
title Hyaluronic acid plasma levels during high versus low tidal volume ventilation in a porcine sepsis model
title_full Hyaluronic acid plasma levels during high versus low tidal volume ventilation in a porcine sepsis model
title_fullStr Hyaluronic acid plasma levels during high versus low tidal volume ventilation in a porcine sepsis model
title_full_unstemmed Hyaluronic acid plasma levels during high versus low tidal volume ventilation in a porcine sepsis model
title_short Hyaluronic acid plasma levels during high versus low tidal volume ventilation in a porcine sepsis model
title_sort hyaluronic acid plasma levels during high versus low tidal volume ventilation in a porcine sepsis model
topic Hyaluronic acid
Pig
Sepsis
Acute respiratory distress syndrome
ARDS
Lung protective ventilation
url https://peerj.com/articles/12649.pdf
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