ABSTRACT
Pneumonectomy is associated with high rates of morbimortality, with postpneumonectomy pulmonary edema being one of the leading causes. An intrinsic inflammatory process following the operation has been considered in its physiopathology. The use of corticosteroids is related to prevention of this edema, but no experimental data are available to support this hypothesis. We evaluated the effect of methylprednisolone on the remaining lungs of rats submitted to left pneumonectomy concerning edema and inflammatory markers. Forty male Wistar rats weighing 300 g underwent left pneumonectomy and were randomized to receive corticosteroids or not. Methylprednisolone at a dose of 10 mg/kg was given before the surgery. After recovery, the animals were sacrificed at 48 and 72 h, when the pO2/FiO2 ratio was determined. Right lung perivascular edema was measured by the index between perivascular and vascular area and neutrophil density by manual count. Tissue expression of vascular endothelial growth factor (VEGF) and transforming growth factor-beta (TGF-β) were evaluated by immunohistochemistry light microscopy. There was perivascular edema formation after 72 h in both groups (P = 0.0031). No difference was observed between operated animals that received corticosteroids and those that did not concerning the pO2/FiO2 ratio, neutrophil density or TGF-β expression. The tissue expression of VEGF was elevated in the animals that received methylprednisolone both 48 and 72 h after surgery (P = 0.0243). Methylprednisolone was unable to enhance gas exchange and avoid an inflammatory infiltrate and TGF-β expression also showed that the inflammatory process was not correlated with pulmonary edema formation. However, the overexpression of VEGF in this group showed that methylprednisolone is related to this elevation.
Subject(s)
Animals , Male , Rats , Anti-Inflammatory Agents/pharmacology , Glucocorticoids/pharmacology , Methylprednisolone/pharmacology , Pulmonary Edema/prevention & control , Transforming Growth Factor beta/biosynthesis , Vascular Endothelial Growth Factors/biosynthesis , Analysis of Variance , Disease Models, Animal , Drug Evaluation, Preclinical , Immunohistochemistry , Lung/metabolism , Pneumonectomy/adverse effects , Pulmonary Edema/etiology , Random Allocation , Rats, Wistar , Respiratory Distress Syndrome/prevention & controlABSTRACT
Pneumonectomy is associated with high mortality and high rates of complications. Postpneumonectomy pulmonary edema is one of the leading causes of mortality. Little is known about its etiologic factors and its association with the inflammatory process. The purpose of the present study was to evaluate the role of pneumonectomy as a cause of pulmonary edema and its association with gas exchange, inflammation, nitric oxide synthase (NOS) expression and vasoconstriction. Forty-two non-specific pathogen-free Wistar rats were included in the study. Eleven animals died during or after the procedure, 21 were submitted to left pneumonectomy and 10 to sham operation. These animals were sacrificed after 48 or 72 h. Perivascular pulmonary edema was more intense in pneumonectomized rats at 72 h (P = 0.0131). Neutrophil density was lower after pneumonectomy in both groups (P = 0.0168). There was higher immunohistochemical expression of eNOS in the pneumonectomy group (P = 0.0208), but no statistically significant difference in the expression of iNOS. The lumen-wall ratio and pO2/FiO2 ratio did not differ between the operated and sham groups after pneumonectomy. Left pneumonectomy caused perivascular pulmonary edema with no elevation of immunohistochemical expression of iNOS or neutrophil density, suggesting the absence of correlation with the inflammatory process or oxidative stress. The increased expression of eNOS may suggest an intrinsic production of NO without signs of vascular reactivity.
Subject(s)
Animals , Rats , Inflammation/etiology , Nitric Oxide Synthase/metabolism , Oxidative Stress/physiology , Pneumonectomy/adverse effects , Pulmonary Circulation/physiology , Pulmonary Edema/etiology , Blood Cell Count , Cell Movement , Immunohistochemistry , Inflammation/physiopathology , Neutrophils , Pulmonary Gas Exchange , Pulmonary Edema/physiopathology , Rats, Wistar , Vasoconstriction/physiologyABSTRACT
Tetralogy of Fallot was diagnosed in a 30 month-old Cocker Spaniel female, through physical, radiographic, electrocardiographic, and echocardiographic exams. The animal was submitted to a palliative surgical correction, the Blalock-Taussig technique, and 46 months after the surgery, no signs of cardiopulmonary decompensation were observed
Subject(s)
Animals , Female , Dogs , Tetralogy of Fallot/diagnosis , Tetralogy of Fallot/surgerySubject(s)
Adolescent , Adult , Middle Aged , Humans , Male , Female , Blood Transfusion, Autologous , Thoracic SurgeryABSTRACT
Neste trabalho, realizado em 20 pacientes portadores de hemotorax traumatico, os autores estudaram as caracteristicas do sangue contido na cavidade pleural, em vistas ao seu aproveitamento para reinfusao. Concluem que este sangue tem caracteristicas muito semelhantes as do sangue circulante, exceto pela reducao dos fatores de coagulacao. Em decorrencia nao e necessario anticoagula-lo para reinfundi-lo
Subject(s)
Adolescent , Adult , Middle Aged , Humans , Male , Female , Blood Transfusion, Autologous , HemothoraxABSTRACT
Neste estudo foram avaliados os valores das concentracoes de sodio e potassio em sangue total em bolsas contendo volumes de Citrate-Phosphate-Dextrose (CPD). Mostramos haver correlacao das concentracoes de sodio com os diferentes volumes coletados nas bolsas e das concentracoes de potassio com o tempo de estocagem
Subject(s)
Humans , Blood Preservation , Glucosephosphates , Potassium , SodiumABSTRACT
E apresentado um dispositivo para realizacao de autotransfusao intra-operatoria, constituido por um recipiente de acrilico, descartavel e capaz de coletar, anticoagular e filtrar o sangue. A autotransfusao foi praticada em 12 casos, sendo 8 em cirurgia de emergencia e 4 em cirurgia seletiva. O dispositivo mostrou-se simples e de facil utilizacao, mas elevada frequencia de contaminacao em amostra de sangue aspirado indica a necessidade de aprimoramento na manipulacao do mesmo
Subject(s)
Humans , Intraoperative Care , Blood Transfusion, AutologousABSTRACT
Os autores apresentam um novo modelo de sonda para alimentacao enteral, inteiramente feito de silastic radiopaco e provido, na sua extremidade distal, de um pequeno balao contendo mercurio. Suas vantagens em relacao as sondas de alimentacao tradicionais sao: menor calibre, extraordinaria flexibilidade e biocompatibilidade e facilidade de migracao espontanea para o duodeno ou jejuno, quando desejada. Sua utilizacao em dez pacientes que dependiam de alimentacao enteral para manutencao ou melhora das suas condicoes nutritivas, revelou resposta satisfatoria ao tratamento, com ausencia de fenomenos irritativos e excelente tolerancia por parte dos enfermos propiciando uma infusao mais constante e mais segura da dieta
Subject(s)
Enteral Nutrition , Intubation, Gastrointestinal , Silicone ElastomersABSTRACT
Os autores apresentam os resultados de um estudo experimental sobre a interposicao de retalhos de dura-mater humana em traqueia de caes. Foram utilizados 22 animais, divididos em tres series, de acordo com o tempo de evolucao do implante, que variou de 1 a 4 meses e meio. O comportamento do implante foi avaliado sob os parametros clinicos e anatomopatologicos. Nao foram observadas alteracoes clinicas em nenhum dos animais e, com relacao aos estudos anatomopatologicos, houve aparente integracao da dura-mater com a traqueia