Pretreatment with adalimumab reduces ventilator-induced lung injury in an experimental model. / Tratamento prévio com adalimumabe reduz lesão pulmonar induzida por ventilação mecânica em um modelo experimental.
Rev Bras Ter Intensiva
; 32(1): 58-65, 2020 Mar.
Article
en En, Pt
| MEDLINE
| ID: mdl-32401991
OBJECTIVE: To determine whether adalimumab administration before mechanical ventilation reduces ventilator-induced lung injury (VILI). METHODS: Eighteen rats randomized into 3 groups underwent mechanical ventilation for 3 hours with a fraction of inspired oxygen = 0.40% including a low tidal volume group (n = 6), where tidal volume = 8mL/kg and positive end-expiratory pressure = 5cmH2O; a high tidal volume group (n = 6), where tidal volume = 35mL/kg and positive end-expiratory pressure = 0; and a pretreated + high tidal volume group (n = 6) where adalimumab (100ug/kg) was administered intraperitoneally 24 hours before mechanical ventilation + tidal volume = 35mL/kg and positive end-expiratory pressure = 0. ANOVA was used to compare histological damage (ATS 2010 Lung Injury Scoring System), pulmonary edema, lung compliance, arterial partial pressure of oxygen, and mean arterial pressure among the groups. RESULTS: After 3 hours of ventilation, the mean histological lung injury score was higher in the high tidal volume group than in the low tidal volume group (0.030 versus 0.0051, respectively, p = 0.003). The high tidal volume group showed diminished lung compliance at 3 hours (p = 0.04) and hypoxemia (p = 0,018 versus control). Pretreated HVt group had an improved histological score, mainly due to a significant reduction in leukocyte infiltration (p = 0.003). CONCLUSION: Histological examination after 3 hours of injurious ventilation revealed ventilator-induced lung injury in the absence of measurable changes in lung mechanics or oxygenation; administering adalimumab before mechanical ventilation reduced lung edema and histological damage.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Respiración Artificial
/
Lesión Pulmonar Inducida por Ventilación Mecánica
/
Adalimumab
Tipo de estudio:
Clinical_trials
/
Prognostic_studies
Límite:
Adult
/
Animals
/
Humans
Idioma:
En
/
Pt
Revista:
Rev Bras Ter Intensiva
Año:
2020
Tipo del documento:
Article
País de afiliación:
Argentina
Pais de publicación:
Brasil