Aspiration-induced lung injury

Rabinovici, Reuven; Neville, Lewis F.; Abdullah, Fizan; Phillip, Dennis-Roger; Vernick, Jerome; Fong, Kei-Lai; Hillegas, L M; Feuerstein, Giora

doi:10.1097/00003246-199508000-00015

Cited by 31 publications

(8 citation statements)

References 19 publications

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“…Commonly used experimental models of ALI include repeated bronchiolar lavage with saline [30], instillation of hydrochloric acid into the tracheobronchial tree [31,32], intravenous infusion of oleic acid [31,33], and intravenous infusion of endotoxin [34]. In a comparative study, Rosenthal et al [35] showed that although each model has its merits, none was closely related to the clinical situation.…”

Section: Discussionmentioning

confidence: 99%

Ovine Smoke/Burn ARDS Model: A New Ventilator-Controlled Smoke Delivery System

Ballard-Croft¹,

Sumpter²,

Broaddus³

et al. 2010

Journal of Surgical Research

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Section: Discussionmentioning

confidence: 99%

Ovine Smoke/Burn ARDS Model: A New Ventilator-Controlled Smoke Delivery System

Ballard-Croft¹,

Sumpter²,

Broaddus³

et al. 2010

Journal of Surgical Research

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“…Most of them were developed in adult-sized animals, and focus on modeling adult respiratory distress syndrome (ARDS), or hypoxia and acute lung injury. Models involving cotton-smoke inhalation,(7, 8) oleic acid instillation,(16) endotoxin injection (9, 17) and hydrochloric acid instillation (18, 19) induce lung injury and strongly activate the systemic inflammatory response, which is not characteristic of pediatric CLD. Saline lavage has been used in pediatric models of acute lung disease since it involves depletion of pulmonary surfactant (20, 21), but does not create PAH and is not generally performed in recovery experiments since severe lung injury is induced (9, 10, 21).…”

Section: Discussionmentioning

confidence: 99%

The Implantable Pediatric Artificial Lung

et al. 2015

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An implantable pediatric artificial lung (PAL) may serve as a bridge to lung transplantation for children with end-stage lung failure (ESLF); however, an animal model of pediatric lung failure is needed to evaluate a PAL’s efficacy before it can enter clinical trials. The objective of this study was to assess ligation of the right pulmonary artery (rPA) as a model for pediatric ESLF. Seven 20-30kg lambs underwent rPA ligation and were recovered and monitored for up to 4 days. Intraoperatively, rPA ligation significantly increased physiologic deadspace fraction (Vd/Vt: baseline=48.6±5.7%, rPA ligation=60.1±5.2%, p=0.012), mean pulmonary arterial pressure (mPPA: baseline=17.4±2.2mmHg, rPA ligation=28.5±5.2mmHg, p<0.001), and arterial partial pressure of carbon dioxide (PaCO2: baseline=40.4±9.3mmHg, rPA ligation=57.3±12.7mmHg, p=0.026). Of the 7 lambs, 3 were unable to be weaned from mechanical ventilation post-operatively, 3 were successfully weaned but suffered cardiorespiratory failure within 4 days, and 1 survived all 4 days. All 4 animals that were successfully weaned from mechanical ventilation had persistent pulmonary hypertension (mPPA=28.6±2.2mmHg) and remained tachypneic (respiratory rate=63±21min−1). Three of the 4 recovered lambs required supplemental oxygen. We conclude that rPA ligation creates the physiologic derangements commonly seen in pediatric end-stage lung failure and may be suitable for testing and implanting a PAL.

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“…Alternatively, there is experimental evidence indicating that intravenous IgG may facilitate, through still unknown mechanisms, enhanced migration of polymorphonuclear leukocytes to the site of infl ammation [29] . Complement-mediated sequestration of neutrophils within the pulmonary microvasculature, proposed to play a role in the pathogenesis of meconium aspiration-and acid aspiration-induced acute lung injury [13,30] , is unlikely a contributing factor in our piglets, since high doses of IVIG may prevent complement fragments from binding to target cells [31] . In line with these earlier observations, it may be speculated from our data that, through enhanced local neutrophil migration, IVIG may promote pulmonary removal of aspirated meconium.…”

Section: Discussionmentioning

confidence: 99%

Intravenous Immunoglobulin G Attenuates Pulmonary Hypertension but Induces Local Neutrophil Influx in Meconium Aspiration in Piglets

Holopainen¹,

Soukka²,

Halkola³

et al. 2005

Neonatology

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Background: Pulmonary hypertension and inflammation are well-identified pathogenetic features in meconium aspiration syndrome of newborns, but current approaches to their treatment or prevention are still often unsatisfactory. Objectives: To investigate the possible protective effects of human intravenous immunoglobulin G (IVIG) on the hypertensive and inflammatory lung injury in severe neonatal meconium aspiration. Methods: Eleven newborn (10–12 days old) ventilated and catheterized piglets that received an intratracheal bolus (3 ml/kg) of a 65-mg/ml mixture of human meconium were studied for 6 h. IVIG was infused in 5 piglets 30 min before meconium administration, and 6 piglets served as controls and received the vehicle only. Results: Meconium instillation induced a biphasic pulmonary hypertensive response, which was significantly diminished by IVIG pretreatment. Similarly, IVIG improved the oxygenation of the piglets, but the intrapulmonary shunt fraction or systemic hemodynamic parameters did not differ between the study groups, except of a minor decrease in the mean arterial blood pressure caused by IVIG. The blood leukocyte count was comparable in the 2 groups. The lung tissue ultrastructural and histological changes, number of apoptotic cells and phospholipase A₂ activity were similar in the 2 groups. The amount of neutrophil accumulation, assessed by myeloperoxidase activity, was however significantly increased in macroscopically damaged lung tissue after IVIG administration. Conclusions: Our results thus indicate that IVIG treatment of newborns with severe meconium aspiration significantly diminishes the pulmonary hypertensive response and improves oxygenation, but the effects do not extend to protection of lung cellular injury.

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Aspiration-induced lung injury

Abstract: Acid aspiration induces lung injury through a complement-dependent mechanism that leads to microvascular permeability defects. Therefore, the possibility that complement inhibitors may have a salutary effect in humans with aspiration-induced lung injury should be investigated.

Cited by 31 publications

References 19 publications

Ovine Smoke/Burn ARDS Model: A New Ventilator-Controlled Smoke Delivery System

Ovine Smoke/Burn ARDS Model: A New Ventilator-Controlled Smoke Delivery System

The Implantable Pediatric Artificial Lung

Intravenous Immunoglobulin G Attenuates Pulmonary Hypertension but Induces Local Neutrophil Influx in Meconium Aspiration in Piglets

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