scholarly journals Hydroxyethyl Starch 6% (130/0.4) Ameliorates Acute Lung Injury in Swine Hemorrhagic Shock

2010 ◽  
Vol 113 (5) ◽  
pp. 1092-1098 ◽  
Author(s):  
Xanthippi Balkamou ◽  
Theodoros Xanthos ◽  
Konstantinos Stroumpoulis ◽  
Dimitrios-Anestis Moutzouris ◽  
Georgios Rokas ◽  
...  
Keyword(s):  
Acute Lung Injury ◽  
Lung Injury ◽  
Hemorrhagic Shock ◽  
Hydroxyethyl Starch ◽  
Capillary Permeability ◽  
Blue Dye ◽  
Ringer’S Solution ◽  
Group A ◽  
Lactated Ringer's Solution ◽  
Group B

Background Traumatic hemorrhage induces acute lung injury. The aim of this study was to assess whether lactated Ringer's solution or 6% hydroxyethyl starch 130/0.4 would have different effects on acute lung injury following hemorrhagic shock. Methods Twenty healthy pigs (19 ± 2 kg) were subjected to hemorrhage and were randomly allocated to two groups: Group A (10 pigs) who received lactated Ringer's solution and Group B (10 pigs) who received hydroxyethyl starch 130/0.4. Hemodynamic response and serum lactate were measured at predetermined phases. Four hours after fluid resuscitation animals were euthanized. Lungs were harvested, and tissue samples were collected. Focal thickening of the alveolar membranes, vascular congestion, number of activated neutrophils, alveolar edema, interstitial neutrophil infiltration, intraalveolar infiltration, and alveolar hemorrhage were assessed. Each feature was given a score from 0 to 3 (0 = absence, 3 = severe). The wet/dry ratio was also calculated, and with the use of Evans blue dye extravasation method, capillary permeability was assessed. Results The total histology score of Group A differed significantly from that of Group B, being significantly lower in Group B animals P = 0.048. The wet/dry weight ratio was significantly higher in the lactated Ringer's group (median [range]) (Group A, 5.1 [0.5]; Group B, 4.9 [0.3]; P = 0.009). The Evans blue dye extravasation method was utilized to study the lung capillary permeability. The animals in Group B showed a marked reduction in microvascular capillary permeability compared with the animals in Group A (Group A, 58.5 [21] mg/g; Group B, 51.5 [14] mg/g; P = 0.017). Conclusions Our study indicates that resuscitation after hemorrhagic shock with hydroxyethyl starch 130/0.4 led to less lung edema and less microvascular permeability in this swine model.

Influence of Fluid Infusion Associated with High-volume Blood Loss on Plasma Propofol Concentrations

2004 ◽  
Vol 100 (4) ◽  
pp. 871-878 ◽  
Author(s):  
Tadayoshi Kurita ◽  
Tomiei Kazama ◽  
Koji Morita ◽  
Shunsuke Fujii ◽  
Masahiro Uraoka ◽  
...  
Keyword(s):  
Steady State ◽  
Blood Loss ◽  
Hydroxyethyl Starch ◽  
High Volume ◽  
Fluid Infusion ◽  
Ringer’S Solution ◽  
Group A ◽  
Volume Blood ◽  
Lactated Ringer's Solution ◽  
Common Clinical Practice

Background It is common clinical practice to use fluid infusion to manage high-volume blood loss until a blood transfusion is performed. The authors investigated the influence of fluid infusion associated with blood loss on the pseudo-steady state propofol concentration. Methods Twenty-seven swine were assigned to a lactated Ringer's solution group, a hydroxyethyl starch group, or a threefold lactated Ringer's solution group (n = 9 in each group). After 180 min of steady state infusion of propofol at a rate of 2 mg.kg(-1).h(-1), hemorrhage and infusion were induced by stepwise bleeding followed by fluid infusion every 30 min. In each of the first two steps, 400 ml blood was collected; thereafter, 200 ml was collected at each step. Just after each bleeding step, fluid infusion was rapidly performed using a volume of lactated Ringer's solution or hydroxyethyl starch equivalent to the blood withdrawn, or a threefold volume of lactated Ringer's solution. Hemodynamic parameters and the plasma propofol concentration were recorded at each step. Results Although the plasma propofol concentration in the lactated Ringer's solution group increased with hemorrhage and infusion, it decreased in both the hydroxyethyl starch and the threefold lactated Ringer's solution groups. The propofol concentration in the hydroxyethyl starch group could be expressed by the following equation: Plasma Propofol Concentration Decrease (%) = 0.80 x Hematocrit Decrease (%) (r2 = 0.83, P < 0.0001). Conclusions When high-volume blood loss is managed by isovolemic hemodilution, the plasma propofol concentration during continuous propofol infusion decreases linearly with the hematocrit decrease.

scholarly journals Comprehensive Analysis of the Profiles of Differentially Expressed mRNAs, lncRNAs, and circRNAs in Phosgene-Induced Acute Lung Injury

2021 ◽  
Vol 2021 ◽  
pp. 1-22
Author(s):  
Yiru Shao ◽  
Zhifeng Jiang ◽  
Daikun He ◽  
Jie Shen
Keyword(s):  
Acute Lung Injury ◽  
Lung Injury ◽  
Therapeutic Potential ◽  
Expression Profiles ◽  
Mirna Gene ◽  
Differentially Expressed ◽  
Control Group ◽  
Group A ◽  
Group B ◽  
Air Control

Phosgene exposure can cause acute lung injury (ALI), for which there is no currently available effective treatment. Mesenchymal stem cells (MSCs) which have been proven to have therapeutic potential and be helpful in the treatment of various diseases, but the mechanisms underlying the function of MSCs against phosgene-induced ALI are still poorly explored. In this study, we compared the expression profiles of mRNAs, lncRNAs, and circRNAs in the lung tissues from rats of three groups—air control (group A), phosgene-exposed (group B), and phosgene + MSCs (group C). The results showed that 389 mRNAs, 198 lncRNAs, and 56 circRNAs were differently expressed between groups A and B; 130 mRNAs, 107 lncRNAs, and 35 circRNAs between groups A and C; and 41 mRNAs, 88 lncRNAs, and 18 circRNAs between groups B and C. GO and KEGG analyses indicated that the differentially expressed RNAs were mainly involved in signal transduction, immune system processes, and cancers. In addition, we used a database to predict target microRNAs (miRNAs) interacting with circRNAs and the R network software package to construct a circRNA-targeted miRNA gene network map. Our study showed new insights into changes in the RNA expression in ALI, contributing to explore the mechanisms underlying the therapeutic potential of MSCs in phosgene-induced ALI.

scholarly journals The role of nitric oxide in treatment of acute lung injury after surgery with extracorporeal circulation

2003 ◽  
Vol 50 (2) ◽  
pp. 49-54 ◽  
Author(s):  
R. Sindjelic ◽  
G. Vlajkovic ◽  
Miljko Ristic ◽  
I. Divac ◽  
D. Markovic
Keyword(s):  
Nitric Oxide ◽  
Acute Lung Injury ◽  
Lung Injury ◽  
Extracorporeal Circulation ◽  
Demographic Data ◽  
Oxygenation Index ◽  
Mechanical Lung Ventilation ◽  
Group A ◽  
Group B

Postoperative acute lung injury (ALI) compromises oxygen transfer across alveolar-capillary membrane with consecutive hypoxia, one of its indicators being reduction of oxygenation index PaO2/FiO2 below 40 kPa (300 mm Hg). Management of ALI includes different procedures like mechanical lung ventilation (MLV), drugs and others. One of the new possibilities for treatment of ALI is nitric oxide (NO) inhalation. The aim of this prospective study was to examine the role of NO inhalation in treatment of ALI. 14 patients with ALI developed immediately after operation with extracorporeal circulation (ECC) were included in the study. Group A (n = 8) inhaled NO and group B (n = 6) did not inhale NO during treatment of ALI. All other therapeutic measures were the same in both groups. The groups were similar in relation to demographic data, type of surgery and duration of ECC. PaO2/FiO2 was calculated before operation (T1), immediately after surgery (T2) and after lung recovery, when the need for MLV stopped (T3). The duration of MLV was also registered. PaO2/FiO2 (kPa) in referent times was in group A 54,9 ? 1,6, 33,8 ? 1,2 and 46,2 ? 0,8 and in group B 52,2 ? 1,1, 33,5 ? 1,5 and 47,3 ? 0,9, respectively. There was a statistically significant decrease of PaO2/FiO2 in T2 and T3 vs T1 in both groups (p < 0,05), while the difference between the groups was not statistically significant. The duration of MLV (h) in group B (28,5 ? 1,6) was statistically significantly shorter than in group A (63,1 ? 8,7) (p < 0,01). According to the results of this study we conclude that NO inhalation during ALI after surgery with ECC significantly reduces the duration of MVL and improves pulmonary recovery .

scholarly journals Comparison between cardiac output values measured by thermodilution and partial carbon dioxide rebreathing in patients with acute lung injury

2004 ◽  
Vol 122 (6) ◽  
pp. 233-238 ◽  
Author(s):  
Jorge Luís dos Santos Valiatti ◽  
José Luiz Gomes do Amaral
Keyword(s):  
Carbon Dioxide ◽  
Cardiac Output ◽  
Acute Lung Injury ◽  
Lung Injury ◽  
Lung Injury Score ◽  
Controlled Study ◽  
Carbon Dioxide Rebreathing ◽  
Significant Difference ◽  
Group A ◽  
Group B

CONTEXT: Thermodilution, which is considered to be a standard technique for measuring the cardiac output in critically ill patients, is not free from relevant risks. There is a need to find alternative, noninvasive, automatic, simple and accurate methods for monitoring cardiac output at the bedside. OBJECTIVE: To compare cardiac output measurements by thermodilution and partial carbon dioxide rebreathing in patients with acute lung injury at two levels of severity (lung injury score, LIS: below 2.5, group A; and above 2.5, group B). TYPE OF STUDY: Comparative, prospective and controlled study. SETTING: Intensive Care Units of two university hospitals. METHODS: Cardiac output was measured by thermodilution and partial carbon dioxide rebreathing. Twenty patients with acute lung failure (PaO2/FiO2 < 300) who were under mechanical ventilation and from whom 294 measurements were taken: 164 measurements in group A (n = 11) and 130 in group B (n = 9), ranging from 14 to 15 determinations per patient. RESULTS: There was a poor positive correlation between the methods studied for the patients from groups A (r = 0.52, p < 0.001) and B (r = 0.47, p < 0.001). The application of the Bland-Altman test made it possible to expose the lack of agreement between the methods (group A: -0.9 ± 2.71 l/min; 95% CI = -1.14 to -0.48; and group B: -1.75 ± 2.05 l/min; 95% CI = -2.11 to -1.4). The comparison of the results (Student t and Mann-Whitney tests) within each group and between the groups showed significant difference (p = 0.000, p < 0.05). DISCUSSION: Errors in estimating CaCO2 (arterial CO2 content) from ETCO2 (end-tidal CO2) and situations of hyperdynamic circulation associated with dead space and/or increased shunt possibly explain our results. CONCLUSION: Under the conditions of this study, the results obtained allow us to conclude that, in patients with acute lung injury, the cardiac output determined by partial rebreathing of CO2 differs from the measurements obtained by thermodilution. This difference becomes greater, the more critical the lung injury is.

Bronchial circulation and cyclooxygenase products in acute lung injury

1987 ◽  
Vol 63 (3) ◽  
pp. 1083-1088 ◽  
Author(s):  
M. E. Deffebach ◽  
S. Lakshminarayan ◽  
W. Kirk ◽  
J. Butler
Keyword(s):  
Acute Lung Injury ◽  
Lung Injury ◽  
Venous Blood ◽  
Lower Lobe ◽  
Bronchial Circulation ◽  
Rate Of Increase ◽  
Group A ◽  
Surgical Preparation ◽  
Pulmonary Arterial ◽  
Group B

The role of cyclooxygenase products in the response of the bronchial circulation to acute lung injury was examined in 30 dogs. By use of an open-chest preparation the left lower lobe (LLL) pulmonary circulation was isolated, continuously weighed, and perfused in situ. The anastomotic bronchial blood flow [Qbr(s-p)] was measured as the rate of increase in the volume of the LLL-perfusion circuit. Four groups of dogs were studied. In group A, six dogs received cyclooxygenase inhibition (COI) with either indomethacin (2 mg/kg) or ibuprofen (10 mg/kg). In group B (n = 10) lung injury caused by airway instillation of glucose (15 mg) with glucose oxidase (500 micrograms/kg) (G/GO) or LLL pulmonary arterial infusion of alpha-napthyl thiourea (ANTU, 2 mg/kg). Group C (n = 10) received COI, and 30 min later injury was induced as above with either ANTU or G/GO. Group D (n = 4) received COI immediately after anesthesia; then, 30 min after completion of the surgical preparation, injury was induced with ANTU or G/GO. After COI, Qbr(s-p) decreased to 35 +/- 9% of the basal values (P less than 0.05). After administration of ANTU or G/GO, Qbr(s-p) increased irrespective of whether COI was present. 6-Ketoprostaglandin F1 alpha (6-keto-PGF1 alpha) and thromboxane B2 (TxB2) were measured by radioimmunoassay in the LLL pulmonary artery and systemic venous blood, demonstrating an increase in 6-keto-PGF1 alpha due to surgical preparation and confirming complete COI in those animals receiving COI immediately after anesthesia. These findings demonstrate that 1) the bronchial circulation is capable of a sevenfold increase in flow in response to acute lung injury.(ABSTRACT TRUNCATED AT 250 WORDS)

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