Comparison of Recruitment Manoeuvres in Ventilated Sheep with Acute Respiratory Distress Syndrome

Engel, Monique; Nowacki, Relana M. E.; Reiss, Lucy Kathleen; Uhlig, Stefan; Willems, Coen H. M. P.; Kloosterboer, Nico; Iwaarden, J. Freek van; Sewing, Alide C. P.; Schumacher, Matthias; Lambermont, Verena A.; Collins, Jennifer J. P.; Zimmermann, Luc J. I.; Vos, Gijs D.; Kramer, Boris W.

doi:10.1007/s00408-012-9428-2

Cited by 10 publications

(8 citation statements)

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“…Twenty-seven adult Texel ewes, age 1 year plus minus 3 months, were intravenously anesthetized with thiopental, intubated, and mechanically ventilated with a pressure-controlled ventilation (PCV) (Servo 900 ventilator, Siemens, Germany) [18,19]. The ventilator settings consisted of a peak pressure to maintain a tidal volume (Vt) of 6-8 mL/kg, a respiratory rate of 15 breaths per minute, an inspiratory time of 50%, a positive end expiratory pressure (PEEP) of 10 cm H 2 O, and a fraction of inspired oxygen (FiO 2 ) of 1.0 [18,19]. A central venous and arterial catheter were inserted.…”

Section: Experimental Protocolmentioning

confidence: 99%

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A comparison of four different models of acute respiratory distress syndrome in sheep

et al. 2020

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Background: Acute respiratory distress syndrome (ARDS) can have various causes. The study objective was to investigate whether different pathophysiologic models of ARDS would show different respiratory, cardiovascular and inflammatory outcomes. Methods: We performed a prospective, randomized study in 27 ventilated ewes inducing ARDS using three different techniques to mimic the pulmonary causes of ARDS (ARDSp): warm saline lavage (n = 6), intratracheal hydrochloric acid (HCl; n = 6), intratracheal albumin (n = 10), and one technique to mimic an extrapulmonary cause of ARDS (ARDSexp): intravenous lipopolysaccharide (LPS iv; n = 5). ARDS was defined when PaO 2 was < 15 kPa (112 mmHg) when ventilated with PEEP 10 cm H 2 O and FiO 2 = 1.0. The effects on gas exchange were investigated by calculating the oxygenation index (OI) and the ventilation efficacy index (VEI) every 30 min for a period of 4 h. Post mortem lung lavage was performed to obtain broncho-alveolar lavage fluid (BALF) to assess lung injury and inflammation. Lung injury and inflammation were assessed by measuring the total number and differentiation of leukocytes, the concentration of protein and disaturated phospholipids, and interleukine-6 and-8 in the BALF. Histology of the lung was evaluated by measuring the mean alveolar size, alveolar wall thickness and the lung injury score system by Matute-Bello et al., as markers of lung injury. The concentration of interleukin-6 was determined in plasma, as a marker of systematic inflammation. Results: The OI and VEI were most affected in the LPS iv group and thereafter the HCl group, after meeting the ARDS criteria. Diastolic blood pressure was lowest in the LPS iv group. There were no significant differences found in the total number and differentiation of leukocytes, the concentration of protein and disaturated phospholipids, or interleukin-8 in the BALF, histology of the lung and the lung injury score. IL-6 in BALF and plasma was highest in the LPS iv group, but no significant differences were found between the other groups. It took a significantly longer period of time to meet the ARDS criteria in the LPS iv group.

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Section: Experimental Protocolmentioning

confidence: 99%

“…A central venous and arterial catheter were inserted. The sheep were sedated during the experiment with intravenously administered midazolam (0.2 mg/kg/h), ketamine (8 mg/kg/h), and paralyzed with repeated boluses of pancuronium (0.1 mg/kg) if needed [18,19]. The sheep were randomly assigned to four different groups.…”

Section: Experimental Protocolmentioning

confidence: 99%

A comparison of four different models of acute respiratory distress syndrome in sheep

et al. 2020

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“…Thus, lung recruitment is proposed as a part of lung protective ventilation. Many reports on the single RM technique have been published (6); however, few studies have shown the clinical efficacy and safety of RRMs in ARDS patients (7). Recruitment manoeuvre as a part of a protective ventilation strategy can reopen poorly aerated alveoli and maintain alveolar recruitment (8).…”

Section: Discussionmentioning

confidence: 99%

Effect of Repeated Recruitment Manoeuvres on Patients with Severe Acute Respiratory Distress Syndrome

et al. 2015

West Indian Med J

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“…Plasma from blood samples were collected every 30 min, spun down and stored at -80ºC. After four hours, the animals were euthanized by an intravenous injection of thiopental (18,19). Thoracotomy was performed and the lungs were removed.…”

Section: Experimental Protocolmentioning

confidence: 99%

“…As markers of gas exchange, OI and VEI were calculated from the cardio-respiratory parameters and blood gas analyses before and after lavage, and every 30 minutes during the 4-hour study period (18,19 (20). This was used as marker for in ammation.…”

Section: Experimental Protocolmentioning

confidence: 99%

A comparison of four different models of acute respiratory distress syndrome in sheep

Engel

Nowacki

Jonker

et al. 2020

Preprint

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Background: Acute respiratory distress syndrome (ARDS) can have various causes. The study objective was to investigate whether different pathophysiologic models of ARDS would show different respiratory, cardiovascular and inflammatory outcomes. Methods: We performed a prospective, randomized study in 27 ventilated ewes inducing ARDS using three different techniques to mimic the pulmonary causes of ARDS (ARDSp): warm saline lavage (n=6), intratracheal hydrochloric acid (HCl; n=6), intratracheal albumin (n=10), and one technique to mimic an extrapulmonary cause of ARDS (ARDSexp): intravenous lipopolysaccharide (LPS iv; n=5). ARDS was defined when PaO 2 was <15kPa (112 mmHg) when ventilated with PEEP 10cm H 2 O and FiO 2 =1.0. The effects on gas exchange were investigated by calculating the oxygenation index (OI) and the ventilation efficacy index (VEI) every 30 minutes for a period of 4 hours. Post mortem lung lavage was performed to obtain broncho-alveolar lavage fluid (BALF) to assess lung injury and inflammation. Lung injury and inflammation were assessed by measuring the total number and differentiation of leukocytes, the concentration of protein and disaturated phospholipids, and interleukine-6 and -8 in the BALF. Histology of the lung was evaluated by measuring the mean alveolar size, alveolar wall thickness and the lung injury score system by Matute-Bello et al., as markers of lung injury. The concentration of interleukin-6 was determined in plasma, as a marker of systematic inflammation. Results: The OI and VEI were most affected in the LPS iv group and thereafter the HCl group, after meeting the ARDS criteria. Diastolic blood pressure was lowest in the LPS iv group. There were no significant differences found in the total number and differentiation of leukocytes, the concentration of protein and disaturated phospholipids, or interleukin-8 in the BALF, histology of the lung and the lung injury score. IL-6 in BALF and plasma was highest in the LPS iv group, but no significant differences were found between the other groups. It took a significantly longer period of time to meet the ARDS criteria in the LPS iv group. Conclusions: The LPS model caused the most severe pulmonary and cardiovascular insufficiency. Surprisingly, there were limited significant differences in lung injury and inflammatory markers, despite the different pathophysiological models, when the clinical definition of ARDS was applied.

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Comparison of Recruitment Manoeuvres in Ventilated Sheep with Acute Respiratory Distress Syndrome

Abstract: Recruitment manoeuvres improved oxygenation, but SMRM was superior, with respect to hemodynamics and pulmonary inflammation, in ventilated sheep suffering from ARDS induced by lung lavage.

Cited by 10 publications

References 47 publications

A comparison of four different models of acute respiratory distress syndrome in sheep

A comparison of four different models of acute respiratory distress syndrome in sheep

Effect of Repeated Recruitment Manoeuvres on Patients with Severe Acute Respiratory Distress Syndrome

A comparison of four different models of acute respiratory distress syndrome in sheep

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