Pre-treatment with dexamethasone attenuates experimental ventilator-induced lung injury

Abstract

Objective: To evaluate the effects that administering dexamethasone before the induction of ventilator-induced lung injury (VILI) has on the temporal evolution of that injury. Methods: Wistar rats were allocated to one of three groups: pre-VILI administration of dexamethasone (dexamethasone group); pre-VILI administration of saline (control group); or ventilation only (sham group). The VILI was induced by ventilation at a high tidal volume. Animals in the dexamethasone and control groups were euthanized at 0, 4, 24, and 168 h after VILI induction. We analyzed arterial blood gases, lung edema, cell counts (total and differential) in the BAL fluid, and lung histology. Results: At 0, 4, and 24 h after VILI induction, acute lung injury (ALI) scores were higher in the control group than in the sham group (p < 0.05). Administration of dexamethasone prior to VILI induction decreased the severity of the lung injury. At 4 h and 24 h after induction, the ALI score in the dexamethasone group was not significantly different from that observed for the sham group and was lower than that observed for the control group (p < 0.05). Neutrophil counts in BAL fluid were increased in the control and dexamethasone groups, peaking at 4 h after VILI induction (p < 0.05). However, the neutrophil counts were lower in the dexamethasone group than in the control group at 4 h and 24 h after induction (p < 0.05). Pre-treatment with dexamethasone also prevented the post-induction oxygenation impairment seen in the control group. Conclusions: Administration of dexamethasone prior to VILI induction attenuates the effects of the injury in Wistar rats. The molecular mechanisms of such injury and the possible clinical role of corticosteroids in VILI have yet to be elucidated.

Dual Delivery of Tetramethylpyrazine and miR-194-5p Using Soft Mesoporous Organosilica Nanoparticles for Acute Lung Injury Therapy

“…Our results showed that mesoporous silica has a high specific surface area, uniform and adjustable pore size, good biocompatibility, extended retention time, and physiological stability. Glucocorticoids (such as dexamethasone), as strong anti-inflammatory drugs, are widely used to improve the clinical symptoms of ALI by limiting tissue damage and acute inflammatory reactions, [29][30][31] so they were used as a positive control in the experiment. NPs@TMP can reduce the level of inflammatory cytokines and inhibit lung oxidative stress in ALI mouse models in vitro.…”

Prevention of mortality in acute lung injury induced by oleic acid: Application of polyherbal decoction (bronco T)

“…OA was injected in all the groups except for group I which was treated with normal saline. In group III, dexamethasone was pre-administered at a dose of 5 mg/kg bw ip ( dos Reis et al, 2016 ) to rats 1 hour before OA administration. In groups, IV and V, the decoction of B.T.…”

Invasive mechanical ventilation in patients with acute respiratory distress syndrome receiving extracorporeal support: a narrative review of strategies to mitigate lung injury

“…The use of glucocorticoids in severe ARDS has been shown to downregulate systemic and pulmonary inflammation and pre-clinical data indicate that dexamethasone attenuates experimental ventilator-induced lung injury [76,77]. A recent multicentre randomised controlled trial examined the efficacy of dexamethasone in moderate-severe ARDS and found that early administration of dexamethasone substantially reduced the duration of invasive ventilation and all-cause 60-day mortality [78].…”