Experimental lung research
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Acute effects of food and cigarette consumption on exhaled breath condensate (EBC) acidity are insufficiently explored. The study aimed to evaluate potential changes in EBC pH within 2 hours following cigarette or food consumption. In 15 healthy smokers, samples were obtained after 10 hours of abstinence from smoking and then 15, 30, 60, and 120 minutes after smoking 1 cigarette. ⋯ These results show that cigarette smoking acutely increases EBC pH in healthy smokers. Smoking status and abstinence from smoking before EBC sampling seems to be important in studies evaluating EBC pH and should be standardized or at least stated in the methodology. Acute effects of food were not found under described study conditions in healthy adults.
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Acute lung injury is a common complication of acute pancreatitis (AP) and contributes to the majority of AP-associated deaths. Although some aspects of AP-induced lung inflammation have been demonstrated, investigation of resultant changes in lung function is limited. The aim of this study was to characterize acute lung injury in L-arginine-induced AP. ⋯ In the lung, MPO activity increased (2.4-fold) from 12 hours, followed by a modest increase in lung edema at 48 hours, with increased BAL cell count (2.5-fold) up to 72 hours (P < .05). In contrast, no significant changes in lung mechanics were evident over the same period. Despite measurable lung inflammation, no significant deterioration in respiratory function resulted from L-arginine-induced AP.
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Cyclical recruitment and derecruitment of lung parenchyma (R/D) remains a serious problem in ALI/ARDS patients, defined as atelectotrauma. Detection of cyclical R/D to titrate the optimal respiratory settings is of high clinical importance. ⋯ Continuous, ultrafast, on-line in vivo measurement of PaO₂ can be provided by an indwelling PaO₂ probe. In addition, monitoring of fast changes in SaO₂ by pulse oximetry technology at the bedside could also be used to detect those fast changes in oxygenation.
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The objective of this study was to determine if low tidal volume (V(t)) ventilation was beneficial when ventilating preterm fetuses. The authors ventilated preterm guinea pig fetuses at gestation day (GD) 67, 3 days before birth, newborn, and 10-day-old (PD10) guinea pigs with low V(t) (6 mL/kg body weight [bw]) and compared them to age-matched fetuses/animals ventilated with higher potentially injurious V(t) (12 mL/kg bw). Lung fluid absorption was measured after intratracheal instillation of 5% albumin in 0.9% NaCl. ⋯ Extracellular signal-regulated kinase (ERK) and MAPK/ERK kinase (MEK) were phosphorylated in the higher V(t)-ventilated guinea pig fetuses. This suggested that a reduced activation of MAP kinases might explain the increased lung fluid absorption in the low V(t)-ventilated fetuses. Thus these data suggest that low V(t) ventilation increases fetal lung fluid absorption and thus may be preferential to use clinically.
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Pulmonary effects of positive end-expiratory pressure and fluid therapy in experimental lung injury.
The separate effects of positive end-expiratory pressure (PEEP) and intravascular volume administration on the histopathologic lung injury were not investigated in experimental lung injury previously. The authors hypothesized that high PEEP and a restrictive volume therapy would yield the best oxygenation and the least degree of lung injury. Pigs (52.8 ± 3.4 kg) underwent saline lavage-induced lung injury. ⋯ When volume therapy was liberal, high PEEP (HighP/Vol+) improved the Pao₂/Fio₂ index (416 ± 80 mm Hg) compared to low PEEP (LowP/Vol+, 189 ± 55 mm Hg; P < .05) but there was no difference in the median (interquartile range) lung injury score: 1.6 (1.2-1.9) and 1.9 (1.4-2.0). High PEEP with restrictive volume therapy (HighP/Vol-) did not further improve oxygenation (400 ± 55 mm Hg) but ameliorated the degree of lung injury: 0.9 (0.8-1.4) (P < .05). In lavage-induced lung injury, high PEEP improved oxygenation, but restrictive volume administration markedly reduced the lung injury score, mainly by reduced edema.