Alveolar preservation with high inflation pressure and intermediate oxygen concentration reduces ischemia-reperfusion injury of the lung

作者：van der Kaaij Niels P^*; Kluin Jolanda; Lachmann Robert A; den Bakker Michael A; Lambrecht Bart N; Lachmann Burkhard; de Bruin Ron W F; Bogers Ad J J C

来源：Journal of Heart and Lung Transplantation, 2012, 31(5): 531-537.

DOI：10.1016/j.healun.2012.02.002

• lung ischemia reperfusion injury
• alveolar oxygen concentration
• inflation pressure
• lung transplantation
• alveolar preservation
• animal model

BACKGROUND: This study investigated the optimal alveolar oxygen concentration and inflation pressure during ischemia that reduces lung ischemia reperfusion injury (URI). %26lt;br%26gt;METHODS: Male Sprague-Dawley rats (n = 66) underwent 150 minutes of left lung ischemia by hilar clamping at an airway inflation pressure (P) of 5 or 30 cm H2O and an oxygen (O) concentration of 0%, 30%, or 100% (P5O0, P5O3, P5O100, P30O0, P30O30 and P30O100 groups). Lungs preserved with 0% oxygen were inflated with 100% nitrogen. Measurements of arterial blood gas values, pulmonary compliance, histology, flow cytometry of bronchoalveolar lavage fluid were performed on day 2 postoperatively. %26lt;br%26gt;RESULTS: Inflation with 30 cm H2O resulted in increased partial pressure of arterial oxygen (Pao(2)) and lung compliance, decreased diffuse alveolar damage, and less infiltration of CD4(+) and CD8(+) lymphocytes and major histocompatibility complex class II-positive (MHCII+) antigen-presenting cells (APCs) in the left lung on day 2 compared with clamping at an airway inflation pressure of 5 cm H2O. The 100% oxygen groups demonstrated a lower Pao and a decreased pulmonary compliance than 30% oxygen groups. More CD8(+) lymphocytes and MHCII APCs were found in the 1350,00 group than in the P5O0 and P5O30 groups. %26lt;br%26gt;CONCLUSION: Alveolar inflation with a pressure of 30 cm H2O and an oxygen concentration of 30% decreases the severity of LIRI. The protective effect is mainly due to hyperinflation and, to a lesser extent, through oxygen concentration.

• 出版日期2012-5