Lung Metabolism and Inflammation during Mechanical Ventilation; An Imaging Approach
Abstract Acute respiratory distress syndrome (ARDS) is a major cause of mortality in critically ill patients. Patients are currently managed by protective ventilation and alveolar recruitment using positive-end expiratory pressure (PEEP). However, the PEEP’s effect on both pulmonary metabolism and r...
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Nature Portfolio
2018
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oai:doaj.org-article:620c9e10585c41399885f05feb281fc92021-12-02T15:07:56ZLung Metabolism and Inflammation during Mechanical Ventilation; An Imaging Approach10.1038/s41598-018-21901-02045-2322https://doaj.org/article/620c9e10585c41399885f05feb281fc92018-02-01T00:00:00Zhttps://doi.org/10.1038/s41598-018-21901-0https://doaj.org/toc/2045-2322Abstract Acute respiratory distress syndrome (ARDS) is a major cause of mortality in critically ill patients. Patients are currently managed by protective ventilation and alveolar recruitment using positive-end expiratory pressure (PEEP). However, the PEEP’s effect on both pulmonary metabolism and regional inflammation is poorly understood. Here, we demonstrate the effect of PEEP on pulmonary anaerobic metabolism in mechanically ventilated injured rats, using hyperpolarized carbon-13 imaging. Pulmonary lactate-to-pyruvate ratio was measured in 21 rats; 14 rats received intratracheal instillation of hydrochloric-acid, while 7 rats received sham saline. 1 hour after acid/saline instillation, PEEP was lowered to 0 cmH2O in 7 injured rats (ZEEP group) and in all sham rats; PEEP was continued in the remaining 7 injured rats (PEEP group). Pulmonary compliance, oxygen saturation, histological injury scores, ICAM-1 expression and myeloperoxidase expression were measured. Lactate-to-pyruvate ratio progressively increased in the dependent lung during mechanical ventilation at ZEEP (p < 0.001), but remained unchanged in PEEP and sham rats. Lactate-to-pyruvate ratio was correlated with hyaline membrane deposition (r = 0.612), edema severity (r = 0.663), ICAM-1 (r = 0.782) and myeloperoxidase expressions (r = 0.817). Anaerobic pulmonary metabolism increases during lung injury progression and is contained by PEEP. Pulmonary lactate-to-pyruvate ratio may indicate in-vivo neutrophil activity due to atelectasis.Mehrdad PourfathiMaurizio CeredaShampa ChatterjeeYi XinStephen KadlecekIan DuncanHooman HamedaniSarmad SiddiquiHarrilla ProfkaJason EhrichKai RuppertRahim R. RiziNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 8, Iss 1, Pp 1-13 (2018) |
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Medicine R Science Q |
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Medicine R Science Q Mehrdad Pourfathi Maurizio Cereda Shampa Chatterjee Yi Xin Stephen Kadlecek Ian Duncan Hooman Hamedani Sarmad Siddiqui Harrilla Profka Jason Ehrich Kai Ruppert Rahim R. Rizi Lung Metabolism and Inflammation during Mechanical Ventilation; An Imaging Approach |
| description |
Abstract Acute respiratory distress syndrome (ARDS) is a major cause of mortality in critically ill patients. Patients are currently managed by protective ventilation and alveolar recruitment using positive-end expiratory pressure (PEEP). However, the PEEP’s effect on both pulmonary metabolism and regional inflammation is poorly understood. Here, we demonstrate the effect of PEEP on pulmonary anaerobic metabolism in mechanically ventilated injured rats, using hyperpolarized carbon-13 imaging. Pulmonary lactate-to-pyruvate ratio was measured in 21 rats; 14 rats received intratracheal instillation of hydrochloric-acid, while 7 rats received sham saline. 1 hour after acid/saline instillation, PEEP was lowered to 0 cmH2O in 7 injured rats (ZEEP group) and in all sham rats; PEEP was continued in the remaining 7 injured rats (PEEP group). Pulmonary compliance, oxygen saturation, histological injury scores, ICAM-1 expression and myeloperoxidase expression were measured. Lactate-to-pyruvate ratio progressively increased in the dependent lung during mechanical ventilation at ZEEP (p < 0.001), but remained unchanged in PEEP and sham rats. Lactate-to-pyruvate ratio was correlated with hyaline membrane deposition (r = 0.612), edema severity (r = 0.663), ICAM-1 (r = 0.782) and myeloperoxidase expressions (r = 0.817). Anaerobic pulmonary metabolism increases during lung injury progression and is contained by PEEP. Pulmonary lactate-to-pyruvate ratio may indicate in-vivo neutrophil activity due to atelectasis. |
| format |
article |
| author |
Mehrdad Pourfathi Maurizio Cereda Shampa Chatterjee Yi Xin Stephen Kadlecek Ian Duncan Hooman Hamedani Sarmad Siddiqui Harrilla Profka Jason Ehrich Kai Ruppert Rahim R. Rizi |
| author_facet |
Mehrdad Pourfathi Maurizio Cereda Shampa Chatterjee Yi Xin Stephen Kadlecek Ian Duncan Hooman Hamedani Sarmad Siddiqui Harrilla Profka Jason Ehrich Kai Ruppert Rahim R. Rizi |
| author_sort |
Mehrdad Pourfathi |
| title |
Lung Metabolism and Inflammation during Mechanical Ventilation; An Imaging Approach |
| title_short |
Lung Metabolism and Inflammation during Mechanical Ventilation; An Imaging Approach |
| title_full |
Lung Metabolism and Inflammation during Mechanical Ventilation; An Imaging Approach |
| title_fullStr |
Lung Metabolism and Inflammation during Mechanical Ventilation; An Imaging Approach |
| title_full_unstemmed |
Lung Metabolism and Inflammation during Mechanical Ventilation; An Imaging Approach |
| title_sort |
lung metabolism and inflammation during mechanical ventilation; an imaging approach |
| publisher |
Nature Portfolio |
| publishDate |
2018 |
| url |
https://doaj.org/article/620c9e10585c41399885f05feb281fc9 |
| work_keys_str_mv |
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