A long-lasting porcine model of ARDS caused by pneumonia and ventilator-induced lung injury
Abstract Background Animal models of acute respiratory distress syndrome (ARDS) do not completely resemble human ARDS, struggling translational research. We aimed to characterize a porcine model of ARDS induced by pneumonia—the most common risk factor in humans—and analyze the additional effect of v...
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | Critical Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13054-023-04512-8 |
| _version_ | 1797801401279053824 |
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| author | Enric Barbeta Marta Arrieta Ana Motos Joaquim Bobi Hua Yang Minlan Yang Giacomo Tanzella Pierluigi Di Ginnatale Stefano Nogas Carmen Rosa Vargas Roberto Cabrera Denise Battaglini Andrea Meli Kasra Kiarostami Nil Vázquez Laia Fernández-Barat Montserrat Rigol Ricard Mellado-Artigas Gerard Frigola Marta Camprubí-Rimblas Pau Ferrer Daniel Martinez Antonio Artigas Carlos Ferrando Miquel Ferrer Antoni Torres |
| author_facet | Enric Barbeta Marta Arrieta Ana Motos Joaquim Bobi Hua Yang Minlan Yang Giacomo Tanzella Pierluigi Di Ginnatale Stefano Nogas Carmen Rosa Vargas Roberto Cabrera Denise Battaglini Andrea Meli Kasra Kiarostami Nil Vázquez Laia Fernández-Barat Montserrat Rigol Ricard Mellado-Artigas Gerard Frigola Marta Camprubí-Rimblas Pau Ferrer Daniel Martinez Antonio Artigas Carlos Ferrando Miquel Ferrer Antoni Torres |
| author_sort | Enric Barbeta |
| collection | DOAJ |
| description | Abstract Background Animal models of acute respiratory distress syndrome (ARDS) do not completely resemble human ARDS, struggling translational research. We aimed to characterize a porcine model of ARDS induced by pneumonia—the most common risk factor in humans—and analyze the additional effect of ventilator-induced lung injury (VILI). Methods Bronchoscopy-guided instillation of a multidrug-resistant Pseudomonas aeruginosa strain was performed in ten healthy pigs. In six animals (pneumonia-with-VILI group), pulmonary damage was further increased by VILI applied 3 h before instillation and until ARDS was diagnosed by PaO2/FiO2 < 150 mmHg. Four animals (pneumonia-without-VILI group) were protectively ventilated 3 h before inoculum and thereafter. Gas exchange, respiratory mechanics, hemodynamics, microbiological studies and inflammatory markers were analyzed during the 96-h experiment. During necropsy, lobar samples were also analyzed. Results All animals from pneumonia-with-VILI group reached Berlin criteria for ARDS diagnosis until the end of experiment. The mean duration under ARDS diagnosis was 46.8 ± 7.7 h; the lowest PaO2/FiO2 was 83 ± 5.45 mmHg. The group of pigs that were not subjected to VILI did not meet ARDS criteria, even when presenting with bilateral pneumonia. Animals developing ARDS presented hemodynamic instability as well as severe hypercapnia despite high-minute ventilation. Unlike the pneumonia-without-VILI group, the ARDS animals presented lower static compliance (p = 0.011) and increased pulmonary permeability (p = 0.013). The highest burden of P. aeruginosa was found at pneumonia diagnosis in all animals, as well as a high inflammatory response shown by a release of interleukin (IL)-6 and IL-8. At histological examination, only animals comprising the pneumonia-with-VILI group presented signs consistent with diffuse alveolar damage. Conclusions In conclusion, we established an accurate pulmonary sepsis-induced ARDS model. |
| first_indexed | 2024-03-13T04:49:55Z |
| format | Article |
| id | doaj.art-dc0dc99849df474c8c336f03b3bb9639 |
| institution | Directory Open Access Journal |
| issn | 1364-8535 |
| language | English |
| last_indexed | 2024-03-13T04:49:55Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Critical Care |
| spelling | doaj.art-dc0dc99849df474c8c336f03b3bb96392023-06-18T11:15:57ZengBMCCritical Care1364-85352023-06-0127111410.1186/s13054-023-04512-8A long-lasting porcine model of ARDS caused by pneumonia and ventilator-induced lung injuryEnric Barbeta0Marta Arrieta1Ana Motos2Joaquim Bobi3Hua Yang4Minlan Yang5Giacomo Tanzella6Pierluigi Di Ginnatale7Stefano Nogas8Carmen Rosa Vargas9Roberto Cabrera10Denise Battaglini11Andrea Meli12Kasra Kiarostami13Nil Vázquez14Laia Fernández-Barat15Montserrat Rigol16Ricard Mellado-Artigas17Gerard Frigola18Marta Camprubí-Rimblas19Pau Ferrer20Daniel Martinez21Antonio Artigas22Carlos Ferrando23Miquel Ferrer24Antoni Torres25Surgical Intensive Care Unit, Hospital Clínic de BarcelonaInstitut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS)CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos IIIInstitut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS)Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS)Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS)Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS)Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS)Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS)Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS)CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos IIIInstitut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS)Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS)Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS)Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS)CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos IIIInstitut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS)Surgical Intensive Care Unit, Hospital Clínic de BarcelonaCritical Care Center, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de BarcelonaCIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos IIIInstitut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS)Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS)CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos IIISurgical Intensive Care Unit, Hospital Clínic de BarcelonaCIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos IIICIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos IIIAbstract Background Animal models of acute respiratory distress syndrome (ARDS) do not completely resemble human ARDS, struggling translational research. We aimed to characterize a porcine model of ARDS induced by pneumonia—the most common risk factor in humans—and analyze the additional effect of ventilator-induced lung injury (VILI). Methods Bronchoscopy-guided instillation of a multidrug-resistant Pseudomonas aeruginosa strain was performed in ten healthy pigs. In six animals (pneumonia-with-VILI group), pulmonary damage was further increased by VILI applied 3 h before instillation and until ARDS was diagnosed by PaO2/FiO2 < 150 mmHg. Four animals (pneumonia-without-VILI group) were protectively ventilated 3 h before inoculum and thereafter. Gas exchange, respiratory mechanics, hemodynamics, microbiological studies and inflammatory markers were analyzed during the 96-h experiment. During necropsy, lobar samples were also analyzed. Results All animals from pneumonia-with-VILI group reached Berlin criteria for ARDS diagnosis until the end of experiment. The mean duration under ARDS diagnosis was 46.8 ± 7.7 h; the lowest PaO2/FiO2 was 83 ± 5.45 mmHg. The group of pigs that were not subjected to VILI did not meet ARDS criteria, even when presenting with bilateral pneumonia. Animals developing ARDS presented hemodynamic instability as well as severe hypercapnia despite high-minute ventilation. Unlike the pneumonia-without-VILI group, the ARDS animals presented lower static compliance (p = 0.011) and increased pulmonary permeability (p = 0.013). The highest burden of P. aeruginosa was found at pneumonia diagnosis in all animals, as well as a high inflammatory response shown by a release of interleukin (IL)-6 and IL-8. At histological examination, only animals comprising the pneumonia-with-VILI group presented signs consistent with diffuse alveolar damage. Conclusions In conclusion, we established an accurate pulmonary sepsis-induced ARDS model.https://doi.org/10.1186/s13054-023-04512-8ARDSVentilator-induced lung injuryPorcine modelPneumoniaDouble hitInjurious mechanical ventilation |
| spellingShingle | Enric Barbeta Marta Arrieta Ana Motos Joaquim Bobi Hua Yang Minlan Yang Giacomo Tanzella Pierluigi Di Ginnatale Stefano Nogas Carmen Rosa Vargas Roberto Cabrera Denise Battaglini Andrea Meli Kasra Kiarostami Nil Vázquez Laia Fernández-Barat Montserrat Rigol Ricard Mellado-Artigas Gerard Frigola Marta Camprubí-Rimblas Pau Ferrer Daniel Martinez Antonio Artigas Carlos Ferrando Miquel Ferrer Antoni Torres A long-lasting porcine model of ARDS caused by pneumonia and ventilator-induced lung injury Critical Care ARDS Ventilator-induced lung injury Porcine model Pneumonia Double hit Injurious mechanical ventilation |
| title | A long-lasting porcine model of ARDS caused by pneumonia and ventilator-induced lung injury |
| title_full | A long-lasting porcine model of ARDS caused by pneumonia and ventilator-induced lung injury |
| title_fullStr | A long-lasting porcine model of ARDS caused by pneumonia and ventilator-induced lung injury |
| title_full_unstemmed | A long-lasting porcine model of ARDS caused by pneumonia and ventilator-induced lung injury |
| title_short | A long-lasting porcine model of ARDS caused by pneumonia and ventilator-induced lung injury |
| title_sort | long lasting porcine model of ards caused by pneumonia and ventilator induced lung injury |
| topic | ARDS Ventilator-induced lung injury Porcine model Pneumonia Double hit Injurious mechanical ventilation |
| url | https://doi.org/10.1186/s13054-023-04512-8 |
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