The link between regional tidal stretch and lung injury during mechanical ventilation

Yen, Seiha and Preissner, Melissa and Bennett, Ellen and Dubsky, Stephen and Carnibella, Richard and O’Toole, Ronan F. and Roddam, Louise and Jones, Heather and Dargaville, Peter A. and Fouras, Andreas and Zosky, Graeme R. (2019) The link between regional tidal stretch and lung injury during mechanical ventilation. American Journal of Respiratory Cell and Molecular Biology, 60 (5). pp. 569-577. ISSN 1044-1549

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Abstract or Summary

The aim of this study was to assess the association between regional tidal volume (Vt), regional functional residual capacity (FRC), and the expression of genes linked with ventilator-induced lung injury. Two groups of BALB/c mice (n = 8 per group) were ventilated for 2 hours using a protective or injurious ventilation strategy, with free-breathing mice used as control animals. Regional Vt and FRC of the ventilated mice was determined by analysis of high-resolution four-dimensional computed tomographic images taken at baseline and after 2 hours of ventilation and corrected for the volume of the region (i.e., specific [s]Vt and specific [s]FRC). RNA concentrations of 21 genes in 10 different lung regions were quantified using a quantitative PCR array. sFRC at baseline varied regionally, independent of ventilation strategy, whereas sVt varied regionally depending on ventilation strategy. The expression of IL-6 (P = 0.04), Ccl2 (P < 0.01), and Ang-2 (P < 0.05) was associated with sVt but not sFRC. The expression of seven other genes varied regionally (IL-1β and RAGE [receptor for advanced glycation end products]) or depended on ventilation strategy (Nfe2l2 [nuclear factor erythroid-derived 2 factor 2], c-fos, and Wnt1) or both (TNF-α and Cxcl2), but it was not associated with regional sFRC or sVt. These observations suggest that regional inflammatory responses to mechanical ventilation are driven primarily by tidal stretch.

Item Type:Journal article
Keywords that describe the item:ventilator-induced lung injury
Subjects:Q Science > QR Microbiology
R Medicine > RA Public aspects of medicine
Divisions:Schools > Centre for Health & Social Practice
ID Code:7196
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Deposited On:10 Feb 2020 05:46
Last Modified:10 Feb 2020 05:46

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