| Author | Cruz, Daniela G. da | |
| Author | Magalhães, Raquel F. de | |
| Author | Padilha, Gisele A. | |
| Author | Silva, Mariana C. da | |
| Author | Braga, Cassia L. | |
| Author | Silva, Adriana R. | |
| Author | Albuquerque, Cassiano F. Gonçalves de | |
| Author | Capelozzi, Vera L. | |
| Author | Samary, Cynthia S. | |
| Author | Pelosi, Paolo | |
| Author | Rocco, Patricia R. M. | |
| Author | Silva, Pedro L. | |
| Access date | 2022-02-05T20:15:44Z | |
| Available date | 2022-02-05T20:15:44Z | |
| Document date | 2021 | |
| Citation | CRUZ, Daniela G. da et al. Impact of positive biphasic pressure during low and high inspiratory efforts in Pseudomonas aeruginosa-induced pneumonia. Plos One, v. 16, n. 2, e0246891, p. 1 - 19, Feb. 2021. | pt_BR |
| ISSN | 1932-6203 | pt_BR |
| URI | https://www.arca.fiocruz.br/handle/icict/51035 | |
| Language | eng | pt_BR |
| Publisher | Public Library of Science | pt_BR |
| Rights | open access | |
| Subject in Portuguese | Pressão bifásica positiva | pt_BR |
| Subject in Portuguese | Impacto | pt_BR |
| Subject in Portuguese | Esforços inspiratórios baixos e altos | pt_BR |
| Subject in Portuguese | Pneumonia induzida | pt_BR |
| Subject in Portuguese | Pseudomonas aeruginosa | pt_BR |
| Title | Impact of positive biphasic pressure during low and high inspiratory efforts in Pseudomonas aeruginosa-induced pneumonia | pt_BR |
| Type | Article | |
| DOI | 10.1371/journal. pone.0246891 | |
| Abstract | Background - During pneumonia, normal alveolar areas coexist adjacently with consolidated areas, and
high inspiratory efforts may predispose to lung damage. To date, no study has evaluated different
degrees of effort during Biphasic positive airway pressure (BIVENT) on lung and diaphragm
damage in experimental pneumonia, though largely used in clinical setting. We
aimed to evaluate lung damage, genes associated with ventilator-induced lung injury (VILI)
and diaphragmatic injury, and blood bacteria in pressure-support ventilation (PSV), BIVENT
with low and high inspiratory efforts in experimental pneumonia. Material and methods - Twenty-eight male Wistar rats (mean ± SD weight, 333±78g) were submitted Pseudomonas
aeruginosa-induced pneumonia. After 24-h, animals were ventilated for 1h in: 1) PSV;
2) BIVENT with low (BIVENTLow-Effort); and 3) BIVENT with high inspiratory effort
(BIVENTHigh-Effort). BIVENT was set at Phigh to achieve VT = 6 ml/kg and Plow at 5 cmH2O
(n = 7/group). High- and low-effort conditions were obtained through anaesthetic infusion
modulation based on neuromuscular drive (P0.1). Lung mechanics, histological damage
score, blood bacteria, and expression of genes related to VILI in lung tissue, and inflammation
in diaphragm tissue. Results - Transpulmonary peak pressure and histological damage score were higher in BIVENTHigh-Effort
compared to BIVENTLow-Effort and PSV [16.1 ± 1.9cmH2O vs 12.8 ± 1.5cmH2O and 12.5 ±
1.6cmH2O, p = 0.015, and p = 0.010; median (interquartile range) 11 (9–13) vs 7 (6–9) and 7 (6–9), p = 0.021, and p = 0.029, respectively]. BIVENTHigh-Effort increased interleukin-6
expression compared to BIVENTLow-Effort (p = 0.035) as well as expressions of cytokineinduced
neutrophil chemoattractant-1, amphiregulin, and type III procollagen compared to
PSV (p = 0.001, p = 0.001, p = 0.004, respectively). Tumour necrosis factor-α expression in
diaphragm tissue and blood bacteria were higher in BIVENTHigh-Effort than BIVENTLow-Effort
(p = 0.002, p = 0.009, respectively). - Conclusion - BIVENT requires careful control of inspiratory effort to avoid lung and diaphragm damage,
as well as blood bacteria. P0.1 might be considered a helpful parameter to optimize inspiratory
effort. | pt_BR |
| Affilliation | Universidade Federal do Rio de Janeiro. Instituto de Biofisica Carlos Chagas Filho. Laboratório de Investigação Pulmonar. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Universidade Federal do Rio de Janeiro. Instituto de Biofisica Carlos Chagas Filho. Laboratório de Investigação Pulmonar. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Universidade Federal do Rio de Janeiro. Instituto de Biofisica Carlos Chagas Filho. Laboratório de Investigação Pulmonar. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Universidade Federal do Rio de Janeiro. Instituto de Biofisica Carlos Chagas Filho. Laboratório de Investigação Pulmonar. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Universidade Federal do Rio de Janeiro. Instituto de Biofisica Carlos Chagas Filho. Laboratório de Investigação Pulmonar. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Imunofarmacologia. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Imunofarmacologia. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Universidade de São Paulo. Escola de Medicina. Departamento de Patologia. São Paulo, SP, Brasil. | pt_BR |
| Affilliation | Universidade Federal do Rio de Janeiro. Instituto de Biofisica Carlos Chagas Filho. Laboratório de Investigação Pulmonar. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Anesthesiology and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences. Genoa, Italy / Department of Surgical Sciences and Integrated Diagnostics, University of Genoa. Genoa, Italy. | pt_BR |
| Affilliation | Universidade Federal do Rio de Janeiro. Instituto de Biofisica Carlos Chagas Filho. Laboratório de Investigação Pulmonar. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Universidade Federal do Rio de Janeiro. Instituto de Biofisica Carlos Chagas Filho. Laboratório de Investigação Pulmonar. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Subject | Positive biphasic pressure | pt_BR |
| Subject | Impact | pt_BR |
| Subject | Low and high inspiratory efforts | pt_BR |
| Subject | Pseudomonas aeruginosa-induced pneumonia | pt_BR |
