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1997年3月1日发布 -更多信息
我们在存在和不存在预先存在的炎症刺激的情况下,检查了通风造型对肺炎介质的影响。55 Sprague-Dawley大鼠随机分为静脉内盐水或脂多糖(LPS)。在自发呼吸50分钟后,切除肺部并随机用四种策略中的一种随机通风:(a)对照(c),潮气量(vt)= 7 cc / kg,正端呼气压力(peep)= 3cm H2O;(b)中等体积,高窥视(MVHP),VT = 15 CC / kg;窥视= 10厘米H2O;(c)中等体积,零窥视(MVZP),VT = 15 CC / kg,PEEP = 0;或(d)大容量,零窥视(HVZP),Vt = 40cc / kg,peep = 0.用零窥视(MVZP,HVZP)通风导致肺顺应性显着降低。通过ELISA测量TNFalpha,IL-1Beta,IL-6,IL-10,MIP-2和IFngamma的肺灌洗水平。与大容量通气(HVZP)组合的零窥视对细胞因子水平有协同作用(例如,TNFalpha与控制的56倍增加)。 Identical end inspiratory lung distention with PEEP (MVHP) resulted in only a three-fold increase in TNFalpha, whereas MVZP produced a six-fold increase in lavage TNFalpha. Northern blot analysis revealed a similar pattern (C, MVHP < MVZP < HVZP) for induction of c-fos mRNA. These data support the concept that mechanical ventilation can have a significant influence on the inflammatory/anti-inflammatory milieu of the lung, and thus may play a role in initiating or propagating a local, and possibly systemic inflammatory response.