Pretreatment with adalimumab reduces ventilator-induced lung injury in an experimental model.
In: Revista Brasileira de terapia intensiva, Jg. 32 (2020-03-01), Heft 1, S. 58-65
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Zugriff:
Objective: To determine whether adalimumab administration before mechanical ventilation reduces ventilator-induced lung injury (VILI).
Methods: Eighteen rats randomized into 3 groups underwent mechanical ventilation for 3 hours with a fraction of inspired oxygen = 0.40% including a low tidal volume group (n = 6), where tidal volume = 8mL/kg and positive end-expiratory pressure = 5cmH2O; a high tidal volume group (n = 6), where tidal volume = 35mL/kg and positive end-expiratory pressure = 0; and a pretreated + high tidal volume group (n = 6) where adalimumab (100ug/kg) was administered intraperitoneally 24 hours before mechanical ventilation + tidal volume = 35mL/kg and positive end-expiratory pressure = 0. ANOVA was used to compare histological damage (ATS 2010 Lung Injury Scoring System), pulmonary edema, lung compliance, arterial partial pressure of oxygen, and mean arterial pressure among the groups.
Results: After 3 hours of ventilation, the mean histological lung injury score was higher in the high tidal volume group than in the low tidal volume group (0.030 versus 0.0051, respectively, p = 0.003). The high tidal volume group showed diminished lung compliance at 3 hours (p = 0.04) and hypoxemia (p = 0,018 versus control). Pretreated HVt group had an improved histological score, mainly due to a significant reduction in leukocyte infiltration (p = 0.003).
Conclusion: Histological examination after 3 hours of injurious ventilation revealed ventilator-induced lung injury in the absence of measurable changes in lung mechanics or oxygenation; administering adalimumab before mechanical ventilation reduced lung edema and histological damage.
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Pretreatment with adalimumab reduces ventilator-induced lung injury in an experimental model.
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Autor/in / Beteiligte Person: | Correger, E ; Marcos, J ; Laguens, G ; Stringa, P ; Cardinal-Fernández, P ; Blanch, L |
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Zeitschrift: | Revista Brasileira de terapia intensiva, Jg. 32 (2020-03-01), Heft 1, S. 58-65 |
Veröffentlichung: | [Rio de Janeiro] : Associação de Medicina Intensiva Brasileira,, 2020 |
Medientyp: | academicJournal |
ISSN: | 1982-4335 (electronic) |
DOI: | 10.5935/0103-507x.20200010 |
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