Nasal ventilation alters mesenchymal cell turnover and improves alveolarization in preterm lambs.
Am J Respir Crit Care Med
; 178(4): 407-18, 2008 Aug 15.
Article
em En
| MEDLINE
| ID: mdl-18556628
ABSTRACT
RATIONALE Bronchopulmonary dysplasia (BPD) is a frequent cause of morbidity in preterm infants that is characterized by prolonged need for ventilatory support in an intensive care environment. BPD is characterized histopathologically by persistently thick, cellular distal airspace walls. In normally developing lungs, by comparison, remodeling of the immature parenchymal architecture is characterized by thinning of the future alveolar walls, a process predicated on cell loss through apoptosis. OBJECTIVES:
We hypothesized that minimizing lung injury, using high-frequency nasal ventilation to provide positive distending pressure with minimal assisted tidal volume displacement, would increase apoptosis and decrease proliferation among mesenchymal cells in the distal airspace walls compared with a conventional mode of support (intermittent mandatory ventilation).METHODS:
Accordingly, we compared two groups of preterm lambs one group managed by high-frequency nasal ventilation and a second group managed by intermittent mandatory ventilation. Each group was maintained for 3 days. MEASUREMENTS AND MAINRESULTS:
Oxygenation and ventilation targets were sustained with lower airway pressures and less supplemental oxygen in the high-frequency nasal ventilation group, in which alveolarization progressed. Thinning of the distal airspace walls was accompanied by more apoptosis, and less proliferation, among mesenchymal cells of the high-frequency nasal ventilation group, based on morphometric, protein abundance, and mRNA expression indices of apoptosis and proliferation.CONCLUSIONS:
Our study shows that high-frequency nasal ventilation preserves the balance between mesenchymal cell apoptosis and proliferation in the distal airspace walls, such that alveolarization progresses.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Alvéolos Pulmonares
/
Displasia Broncopulmonar
/
Ventilação de Alta Frequência
/
Divisão Celular
/
Ventilação com Pressão Positiva Intermitente
/
Apoptose
/
Pressão Positiva Contínua nas Vias Aéreas
/
Mesoderma
Limite:
Animals
/
Humans
/
Newborn
Idioma:
En
Revista:
Am J Respir Crit Care Med
Assunto da revista:
TERAPIA INTENSIVA
Ano de publicação:
2008
Tipo de documento:
Article
País de afiliação:
Estados Unidos