کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2765560 1150967 2010 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
A single recruitment maneuver in ventilated critically ill children can translocate pulmonary cytokines into the circulation
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیهوشی و پزشکی درد
پیش نمایش صفحه اول مقاله
A single recruitment maneuver in ventilated critically ill children can translocate pulmonary cytokines into the circulation
چکیده انگلیسی

IntroductionRecruitment maneuvers (RMs) are advocated to prevent pulmonary collapse during low tidal volume ventilation and improve oxygenation. However, convincing clinical evidence for improved outcome is lacking. Recent experimental studies demonstrate that RMs translocate pulmonary inflammatory mediators into the circulation. To determine whether a single RM in ventilated children affects pulmonary and systemic cytokine levels, we performed a prospective intervention study.MethodsCardiorespiratory stable ventilated patients (0.5-45 months, n = 7) with acute lung injury were subjected to an RM determining opening and closing pressures (peak inspiratory pressure ≤45 cmH2O, positive end expiratory pressure (PEEP) ≤30 cmH2O). Before and after RM, cardiorespiratory parameters and ventilator settings were recorded, blood gas analysis performed, and bronchoalveolar lavage fluid and plasma TNF-α, IL-1β, IL-6, IL-8, and IL-10 concentrations were determined.ResultsFifteen minutes after the RM, an increase was observed in plasma tumor necrosis factor-α (400% ± 390% of baseline, P = .04), IL-6 (120% ± 35%, P = .08), and IL-1β (520% ± 535%, P = .04), which decreased at T = 60 minutes, hence indicative of translocation. Recruitment maneuver did not change the plasma levels of the anti-inflammatory IL-10 (105% ± 12%, P = .5). Apart from a nonsignificant increase of IL-8 after 360 minutes (415% ± 590%,P = .1), bronchoalveolar cytokine levels were not influenced by the RM. No increase in oxygenation or improvement of lung kinetics was observed.ConclusionsA single RM can translocate pro-inflammatory cytokines from the alveolar space into the systemic circulation in ventilated critically ill children.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Critical Care - Volume 25, Issue 1, March 2010, Pages 10–15
نویسندگان
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