Effects of multiple pulmonary aspirations of enteral solutions on lung tissue damage

Umuroğlu, Tümay; Takıl, Arzu; Irmak, Pınar; Yıldızeli, Bedrettin; Ahıskalı, Rengin; Doğan, Varlık; Göğüş, F. Yılmaz

doi:10.1016/j.clnu.2005.08.011

Cited by 6 publications

(4 citation statements)

References 15 publications

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“…In our study, we observed a signifi cant increase in PICI, ASI, AED, AEX, and AHI in lung tissue in the histopathological examination after FOR and HCl aspiration. This fi nding is similar to that reported in other working models, which demonstrated a comparable damage after gastric content aspiration (20,24,25).…”

Section: Discussionsupporting

confidence: 91%

Ameliorative effect of Leflunomide on lung injury following an aspiration

Yılmaz¹,

Torun²,

Murat³

et al. 2015

BLL

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Background: We aimed to investigate the therapeutic effectiveness of lefl unomide (LEF) in lung injury after an aspiration of unknown pathophysiology. Material and methods: Forty-two healthy Sprague Dawley rats were anesthetized and allocated to six experimental groups: saline (S) aspirated, S+LEF, hydrochloric acid (HCl) aspirated, HCl+LEF, formula aspirated (FOR), and FOR+LEF. The treatment groups (S+LEF, HCl+LEF, and FOR+LEF) received 20 mg/kg/day intraperitoneal (i.p.) injection of LEF for seven days. At the end of the seven days, blood and tissue samples were taken from the rats for histopathological, biochemical, and immunohistochemical examination. Results: There was a signifi cant increase in serum levels of YKL-40, a chitinase-like protein, in the HCl group after the aspiration (p < 0.01). The increase in serum YKL-40 levels decreased signifi cantly with LEF treatment (p <0.01). There was no signifi cant difference in serum YKL-40 levels in the FOR group compared to the control group at pretreatment and in the FOR+LEF group at post-treatment. There was a signifi cant increase in serum thiobarbituric acid-reactive species (TBARS) values in the HCl and FOR groups compared to the control group (p =0.001 and p<0.01, respectively). In both treatment groups, the serum TBARS values signifi cantly decreased after treatment with LEF (p = 0.001 and p < 0.05, respectively). There was a signifi cant improvement in the histopathological scores, which deteriorated after the aspiration, and in the number of inducible nitric oxide synthase (iNOS)-positive cells after treatment with LEF. Conclusions: LEF can be a useful agent in the treatment of gastric content aspiration-induced acute lung injury (ALI) (Tab. 1, Fig. 5, Ref. 43). Text in PDF www.elis.sk.

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Section: Discussionsupporting

confidence: 91%

Ameliorative effect of Leflunomide on lung injury following an aspiration

Yılmaz¹,

Torun²,

Murat³

et al. 2015

BLL

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“…A standard diagnostic finding in lipoid pneumonia is the observation of macrophages (Ahrens et al 1999), which help in the diagnosis of chronic pulmonary aspiration (Bauer and Lyrene 1999;Umuroglu et al 2006). These findings suggested that multiple pulmonary aspirations of the enteral solutions studied resulted in chronic, rather than acute or subacute, histopathological changes.…”

Section: Discussionmentioning

confidence: 90%

The effect of hyperbaric oxygen treatment on aspiration pneumonia

et al. 2011

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We have studied whether hyperbaric oxygen (HBO) prevents different pulmonary aspiration materials-induced lung injury in rats. The experiments were designed in 60 Sprague-Dawley rats, ranging in weight from 250 to 300 g, randomly allotted into one of six groups (n = 10): saline control, Biosorb Energy Plus (BIO), hydrochloric acid (HCl), saline + HBO treated, BIO + HBO treated, and HCl + HBO treated. Saline, BIO, HCl were injected into the lungs in a volume of 2 ml/kg. A total of seven HBO sessions were performed at 2,4 atm 100% oxygen for 90 min at 6-h intervals. Seven days later, rats were sacrificed, and both lungs in all groups were examined biochemically and histopathologically. Our findings show that HBO inhibits the inflammatory response reducing significantly (P < 0.05) peribronchial inflammatory cell infiltration, alveolar septal infiltration, alveolar edema, alveolar exudate, alveolar histiocytes, interstitial fibrosis, granuloma, and necrosis formation in different pulmonary aspiration models. Pulmonar aspiration significantly increased the tissue HP content, malondialdehyde (MDA) levels and decreased (P < 0.05) the antioxidant enzyme (SOD, GSH-Px) activities. HBO treatment significantly (P < 0.05) decreased the elevated tissue HP content, and MDA levels and prevented inhibition of SOD, and GSH-Px (P < 0.05) enzymes in the tissues. Furthermore, there is a significant reduction in the activity of inducible nitric oxide synthase, TUNEL and arise in the expression of surfactant protein D in lung tissue of different pulmonary aspiration models with HBO therapy. It was concluded that HBO treatment might be beneficial in lung injury, therefore, shows potential for clinical use.

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“…3,6e8,27,30 Critically ill patients receiving nasoenteric feeding may easily develop aspiration pneumonia, as a result of a retrograde regurgitation of feeding solutions. 31 In some countries the digestive form of Chagas disease, where patients with megacolon have severe and prolonged periods of constipation (over 60 days), should also be remembered. 32,33 The combination of two factors (constipation caused by functional disorder of colon, and tendency to aspiration due to megaesophagus) enhances the risk of lipoid pneumonia in patients with Chagas disease.…”

Section: Etiopathogenesis and Pathophysiologymentioning

confidence: 99%

Exogenous lipoid pneumonia. Clinical and radiological manifestations

Marchiori

Zanetti

Mano

et al. 2011

Respiratory Medicine

143

171

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Lipoid pneumonia results from the pulmonary accumulation of endogenous or exogenous lipids. Host tissue reactions to the inhaled substances differ according to their chemical characteristics. Symptoms can vary significantly among individuals, ranging from asymptomatic to severe, life-threatening disease. Acute, sometimes fatal, cases can occur, but the disease is usually indolent. Possible complications include superinfection by nontuberculous mycobacteria, pulmonary fibrosis, respiratory insufficiency, cor pulmonale, and hypercalcemia. The radiological findings are nonspecific, and the disease presents with variable patterns and distribution. For this reason, lipoid pneumonia may mimic many other diseases. The diagnosis of exogenous lipoid pneumonia is based on a history of exposure to oil, characteristic radiological findings, and the presence of lipid-laden macrophages on sputum or BAL analysis. High-resolution computed tomography (HRCT) is the best imaging modality for the diagnosis of lipoid pneumonia. The most characteristic CT finding in LP is the presence of negative attenuation values within areas of consolidation. There are currently no studies in the literature that define the best therapeutic option. However, there is a consensus that the key measure is identifying and discontinuing exposure to the offending agent. Treatment in patients without clinical symptoms remains controversial, but in patients with diffuse pulmonary damage, aggressive therapies have been reported. They include whole lung lavage, systemic corticosteroids, and thoracoscopy with surgical debridement.

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Effects of multiple pulmonary aspirations of enteral solutions on lung tissue damage

Cited by 6 publications

References 15 publications

Ameliorative effect of Leflunomide on lung injury following an aspiration

Ameliorative effect of Leflunomide on lung injury following an aspiration

The effect of hyperbaric oxygen treatment on aspiration pneumonia

Exogenous lipoid pneumonia. Clinical and radiological manifestations

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