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Effects of different peep levels on mesenteric leukocyte-endothelial interactions in rats during mechanical ventilation
Aikawa, Priscila; Farsky, Sandra Helena Poliselli; Oliveira, Maria Aparecida de; Pazetti, Rogério; Mauad, Thaís; Sannomiya, Paulina; Nakagawa, Naomi Kondo.
  • Aikawa, Priscila; Universidade de São Paulo. Faculdade de Medicina. Department of Physiotherapy, Communication Science & Disorders and Occupacional Therapy. LIM-34. São Paulo. BR
  • Farsky, Sandra Helena Poliselli; University of São Paulo. School of Pharmacy. Department of Clinical and Toxicological Analyses. São Paulo. BR
  • Oliveira, Maria Aparecida de; University of São Paulo. Institute of Biomedical Sciences. Department of Pharmacology. Sao Paulo. BR
  • Pazetti, Rogério; Universidade de São Paulo. Faculdade de Medicina. Department of Cardiopneumology. LIM-11 and LIM-61. São Paulo. BR
  • Mauad, Thaís; Universidade de São Paulo. Faculdade de Medicina. Department of Pathology. LIM-05. São Paulo. BR
  • Sannomiya, Paulina; Universidade de São Paulo. Faculdade de Medicina. Department of Cardiopneumology. LIM-11 and LIM-61. São Paulo. BR
  • Nakagawa, Naomi Kondo; Universidade de São Paulo. Faculdade de Medicina. Department of Physiotherapy, Communication Science & Disorders and Occupacional Therapy. LIM-34. São Paulo. BR
Clinics ; 64(5): 443-450, 2009. ilus, graf, tab
Article in English | LILACS | ID: lil-514746
ABSTRACT

INTRODUCTION:

Mechanical ventilation with positive end expiratory pressure (PEEP) improves oxygenation and treats acute pulmonary failure. However, increased intrathoracic pressure may cause regional blood flow alterations that may contribute to mesenteric ischemia and gastrointestinal failure. We investigated the effects of different PEEP levels on mesenteric leukocyte-endothelial interactions.

METHODS:

Forty-four male Wistar rats were initially anesthetized (Pentobarbital I.P. 50mg/kg) and randomly assigned to one of the following groups 1) NAIVE (only anesthesia; n=9), 2) PEEP 0 (PEEP of 0 cmH2O, n=13), 3) PEEP 5 (PEEP of 5 cmH2O, n=12), and 4) PEEP 10 (PEEP of 10 cmH2O, n=13). Positive end expiratory pressure groups were tracheostomized and mechanically ventilated with a tidal volume of 10 mL/kg, respiratory rate of 70 rpm, and inspired oxygen fraction of 1. Animals were maintained under isoflurane anesthesia. After two hours, laparotomy was performed, and leukocyte-endothelial interactions were evaluated by intravital microscopy.

RESULTS:

No significant changes were observed in mean arterial blood pressure among groups during the study. Tracheal peak pressure was smaller in PEEP 5 compared with PEEP 0 and PEEP 10 groups (11, 15, and 16 cmH2O, respectively; p<0.05). After two hours of MV, there were no differences among NAIVE, PEEP 0 and PEEP 5 groups in the number of rollers (118±9,127±14 and 147±26 cells/10minutes, respectively), adherent leukocytes (3±1,3±1 and 4±2 cells/100µm venule length, respectively), and migrated leukocytes (2±1,2±1 and 2±1 cells/5,000µm², respectively) at the mesentery. However, the PEEP 10 group exhibited an increase in the number of rolling, adherent and migrated leukocytes (188±15 cells / 10 min, 8±1 cells / 100 µm and 12±1 cells / 5,000 µm², respectively; p<0.05).

CONCLUSIONS:

High intrathoracic pressure was harmful to mesenteric microcirculation in the experimental model of rats with normal lungs and ...
Subject(s)

Full text: Available Index: LILACS (Americas) Main subject: Splanchnic Circulation / Endothelium, Vascular / Positive-Pressure Respiration / Leukocytes Limits: Animals Language: English Journal: Clinics Journal subject: Medicine Year: 2009 Type: Article / Project document Affiliation country: Brazil Institution/Affiliation country: Universidade de São Paulo/BR / University of São Paulo/BR

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Full text: Available Index: LILACS (Americas) Main subject: Splanchnic Circulation / Endothelium, Vascular / Positive-Pressure Respiration / Leukocytes Limits: Animals Language: English Journal: Clinics Journal subject: Medicine Year: 2009 Type: Article / Project document Affiliation country: Brazil Institution/Affiliation country: Universidade de São Paulo/BR / University of São Paulo/BR