TY  - THES
A1  - Zollhoefer, Bernd
T1  - Ergebnisse der Hochfrequenzoszillation auf die pulmonale Entzündungsreaktion beim Lavage induzierten akuten Lungenversagen im Langzeit Großtiermodell
T1  - Effects of high frequency oscillatory ventilation on pulmonary inflammation during lavage induced acute lung injury in a long term animal model
N2  - Ergebnisse der Hochfrequenzoszillation auf die pulmonale Entzündungsreaktion beim Lavage induzierten akuten Lungenversagen im Langzeit Großtiermodell
N2  - Objective: High-frequency oscillatory ventilation (HFOV) may reduce ventilator-induced lung injury in experimental neonatal respiratory distress. However, these data permit no conclusions for large animals or adult patients with acute respiratory distress syndrome (ARDS), because in neonates higher frequencies and lower amplitudes can be used, resulting in lower tidal volumes (VT) and airway pressures. The aim of this study was to compare gas exchange and inflammatory cytokine expression during lung-protective pressurecontrolled ventilation (PCV) and HFOV in a long-term large-animal model of ARDS. Design: Prospective, randomized, controlled pilot study. Setting: University animal laboratory. Subjects: Sixteen female pigs (55.3± 3.9 kg). Interventions: After induction of ARDS by repeated lavage, the animals were randomly assigned to PCV (VT = 6 ml/kg) and HFOV (6 Hz). After lung injury, a standardised lung recruitment was performed in both groups, and ventilation was continued for 24 h. Measurements and results: After lung recruitment sustained improvements in the oxygenation index were observed in both groups. The mean airway pressure (mPaw) was significantly lower in the HFOV group during the experiment ( p < 0.01). The messenger RNA expression of IL-1-beta in lung tissue was significantly lower in the HFOV-treated animals ( p < 0.01). Conclusions: These data suggest that HFOV compared with conventional lung-protective ventilation can reduce lung inflammation in a large-animal 24-h model of ARDS. Furthermore, it was shown that lung recruitment leads to sustained improvements in gas exchange with a significantly lower mPaw when HFOV is used.
KW  - ARDS
KW  - ARDS
KW  - HFOV
KW  - Tiermodell
KW  - VILI
KW  - Lungenschädigung
KW  - mRNA
KW  - ELISA
KW  - PCR
KW  - ARDS
KW  - HFOV
KW  - VILI
KW  - mRNA
KW  - ELISA
KW  - PCR
Y1  - 2009
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-47527
ER  -