外冷亚低温可改善急性肺损伤家兔模型的肺功能,减轻肺部炎症反应和损伤。

IF 2.1 4区 医学 Q2 SURGERY Journal of Investigative Surgery Pub Date : 2022-07-01 Epub Date: 2022-04-17 DOI:10.1080/08941939.2022.2064010
Onat Akyol, Serdar Demirgan, Aslıhan Şengelen, Hasan Cem Güneyli, Duygu Sultan Oran, Funda Yıldırım, Damla Haktanır, Mehmet Salih Sevdi, Kerem Erkalp, Ayşin Selcan
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引用次数: 1

摘要

目的:靶向温度管理(TTM)和治疗性低温(TH)主要通过减少炎症反应来发挥器官保护作用。在这里,我们的目的是首次确定在急性肺损伤/急性呼吸窘迫综合征(ALI/ARDS)的两次撞击兔模型中,外部冷却的轻度TH(一种简单而廉价的方法)是否安全甚至有益。方法:将22只6个月大的新西兰兔随机分为健康对照组(HC)、模型组(ALI)和低温外冷组(ALI-HT)。ALI-HT组在通过轻度肺灌洗和非保护性通气诱导ALI/ARDS后,开始亚低温(体温33-34 °C)。通过记录呼吸参数,将所有兔子常规通气6小时。最后,对肺组织病理学和炎症反应进行评估。结果:低温与较高的氧饱和度有关,导致P/F比(PaO2/FiO2)、氧合指数、平均气道压力和PaCO2的部分改善,但不影响乳酸水平。ALI-HT组的组织病理学损伤评分较低(充血、水肿、肺气肿、肺不张和PMN浸润)。此外,由于体温过低,肺组织和血清样本中的肿瘤坏死因子α(TNF-α)、白细胞介素-6和-8水平显著降低。结论:轻度TH加外冷可减轻肺部炎症和损伤,但可部分改善气体交换。我们的研究结果强调,体温控制可能是调节ALI/ARDS中细胞因子产生和呼吸参数的一种潜在的支持性治疗选择。
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Mild Hypothermia via External Cooling Improves Lung Function and Alleviates Pulmonary Inflammatory Response and Damage in Two-Hit Rabbit Model of Acute Lung Injury.

Objectives: Targeted temperature management (TTM) with therapeutic hypothermia (TH) has an organ-protective effect by mainly reducing inflammatory response. Here, our objective was to determine, for the first time, whether mild TH with external cooling, a simple and inexpensive method, could be safe or even beneficial in two-hit rabbit model of acute lung injury/acute respiratory distress syndrome (ALI/ARDS).

Methods: Twenty-two New Zealand rabbits (6-month-old) were randomly divided into healthy control (HC) with conventional ventilation, but without injury, model group (ALI), and hypothermia group with external cooling (ALI-HT). After induction of ALI/ARDS through mild lung-lavages followed by non-protective ventilation, mild hypothermia was started in ALI-HT group (body temperature of 33-34 °C). All rabbits were conventionally ventilated for an additional 6-h by recording respiratory parameters. Finally, lung histopathology and inflammatory response were evaluated.

Results: Hypothermia was associated with higher oxygen saturation, resulting in partial improvement in the P/F ratio (PaO2/FiO2), oxygenation index, mean airway pressure, and PaCO2, but did not affect lactate levels. The ALI-HT group had lower histopathological injury scores (hyperemia, edema, emphysema, atelectasis, and PMN infiltration). Further, tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6 and -8 levels in lung tissue and serum samples markedly reduced due to hypothermia.

Conclusion: Mild TH with external cooling reduced lung inflammation and damage, whereas it resulted in partial improvement in gas exchanges. Our findings highlight that body temperature control may be a potentially supportive therapeutic option for regulating cytokine production and respiratory parameters in ALI/ARDS.

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来源期刊
CiteScore
4.20
自引率
0.00%
发文量
114
审稿时长
6-12 weeks
期刊介绍: Journal of Investigative Surgery publishes peer-reviewed scientific articles for the advancement of surgery, to the ultimate benefit of patient care and rehabilitation. It is the only journal that encompasses the individual and collaborative efforts of scientists in human and veterinary medicine, dentistry, basic and applied sciences, engineering, and law and ethics. The journal is dedicated to the publication of outstanding articles of interest to the surgical research community.
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