科研之友
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摘要
Objective: Chest trauma remains a leading cause of trauma-death. Since lung contusion is one of the most important lesions implicated, the aim of this experimental study was to evaluate the cardiorespiratory consequences of an isolated lung contusion model. %26lt;br%26gt;Methods: Twenty-eight anesthetized pigs were studied during four hours. We induced a right lung contusion with five bolt shots (70 joules each) using a 22-caliber charge in twenty of them. Eight others pigs constituted the control group. The trauma consequences were assessed by histology, measurements of arterial oxygenation, plasma cytokines, pressure-volume mechanics, hemodynamic monitoring using the PiCCO system and a pulmonary artery catheter. The extra-vascular lung water was measured using the gravimetric method. %26lt;br%26gt;Results: Histology confirmed an isolated right lung contusion without cardiac injury. Compared to baseline values, the trauma group was characterized by a decrease in cardiac index (3.3 +/- 0.8 vs 3.9 +/- 1.2 l/min/m(2); P %26lt; .05) and mean arterial pressure (80 +/- 21 vs 95 +/- 16 mmHg; P %26lt; .05) without preload or afterload modification. Oxygenation (PaO2/FiO(2): 349 +/- 87 vs 440 +/- 75; P %26lt; .05) and static compliance (26.3 +/- 7.4 vs 30.3 +/- 7.8 ml/cmH(2)O; P %26lt; .05) were also impaired during two hours compared to baseline. No edema was noticed in either group whatever the lung considered. All measured cytokines were below the detection threshold. %26lt;br%26gt;Conclusions: An isolated right lung contusion is associated with rapid but transient cardiorespiratory impairments. Despite the large extent of the lung contusion, no pulmonary edema appeared during the period studied.
- 出版日期2013-8
