Time-Controlled Adaptive Ventilation Versus Volume-Controlled Ventilation in Experimental Pneumonia.

OBJECTIVES: We hypothesized that a time-controlled adaptive ventilation strategy would open and stabilize alveoli by controlling inspiratory and expiratory duration. Time-controlled adaptive ventilation was compared with volume-controlled ventilation at the same levels of mean airway pressure and positive end-release pressure (time-controlled adaptive ventilation)/positive end-expiratory pressure (volume-controlled ventilation) in a Pseudomonas aeruginosa-induced pneumonia model. DESIGN: Animal study. SETTING: Laboratory investigation. SUBJECTS: Twenty-one Wistar rats. INTERVENTIONS: Twenty-four hours after pneumonia induction, Wistar rats (n = 7) were ventilated with time-controlled adaptive ventilation (tidal volume = 8 mL/kg, airway pressure release ventilation for a Thigh = 0.75-0.85 s, release pressure (Plow) set at 0 cm H2O, and generating a positive end-release pressure = 1.6 cm H2O applied for Tlow = 0.11-0.14 s). The expiratory flow was terminated at 75% of the expiratory flow peak. An additional 14 animals were ventilated using volume-controlled ventilation, maintaining similar time-controlled adaptive ventilation levels of positive end-release pressure (positive end-expiratory pressure=1.6 cm H2O) and mean airway pressure = 10 cm H2O. Additional nonventilated animals (n = 7) were used for analysis of molecular biology markers. MEASUREMENTS AND MAIN RESULTS: After 1 hour of mechanical ventilation, the heterogeneity score, the expression of pro-inflammatory biomarkers interleukin-6 and cytokine-induced neutrophil chemoattractant-1 in lung tissue were significantly lower in the time-controlled adaptive ventilation than volume-controlled ventilation with similar mean airway pressure groups (p = 0.008, p = 0.011, and p = 0.011, respectively). Epithelial cell integrity, measured by E-cadherin tissue expression, was higher in time-controlled adaptive ventilation than volume-controlled ventilation with similar mean airway pressure (p = 0.004). Time-controlled adaptive ventilation animals had bacteremia counts lower than volume-controlled ventilation with similar mean airway pressure animals, while time-controlled adaptive ventilation and volume-controlled ventilation with similar positive end-release pressure animals had similar colony-forming unit counts. In addition, lung edema and cytokine-induced neutrophil chemoattractant-1 gene expression were more reduced in time-controlled adaptive ventilation than volume-controlled ventilation with similar positive end-release pressure groups. CONCLUSIONS: In the model of pneumonia used herein, at the same tidal volume and mean airway pressure, time-controlled adaptive ventilation, compared with volume-controlled ventilation, was associated with less lung damage and bacteremia and reduced gene expression of mediators associated with inflammation.

Enteropatógenos bacterianos em peixes criados em uma estação de reciclagem de nutrientes e no ecossistema relacionado / Bacterial enteropathogens from fishes of a nutrient recycle system and its ecosystem

Avaliou-se a presença de enteropatógenos bacterianos em 72 amostras obtidas a partir de peixes criados em sistema de reciclagem de nutrientes, em estação experimental, no município de Petrópolis, RJ. Paralelamente, foram obtidas amostras do lodo utilizado como adubo orgânico e da cama de aves localizada na área interna dos tanques criatórios. A metodologia empregada incluiu o pré-enriquecimento em Caldo Lactosado e Agua Peptonada Tamponada, seguido de enriquecimento em Agua Peptonada Alcalina (pH 8,4-8,6) e subseqüente semeadura em Agar GSP para o isolamento de Aeromonas spp. e Plesiomonas shigelloides. Para os demais microrganismos, alíquotas de 1ml foram inoculadas nos meios de enriquecimento Caldo Rappaport-Vassiliadis e Caldo Tetrationato de Kauffmann com posterior semeadura em Agar Entérico Hektoen e Agar Salmonella-Shigella. Com a finalidade de monitorar o índice de coliformes fecais, visando conhecer a qualidade da água para este sistema, paralelamente à coleta de peixes foram avaliadas amostras de água dos tanques criatórios e de macrófitas. No cômputo geral foram isoladas 116 cepas de enteropatógenos bacterianos, destacando-se Aeromonas spp (67,2 por cento) com 9 espécies (A. veronii biogrupo sobria, A. hydrophila, A. sobria, A. trota, A.eucrenophila, A. veronii biog. veronii, A. media, A. caviae e A jandaei) e Aeromonas spp., seguido de Edwardsiella tarda (16,4 por cento), Plesiomonas shigelloides (12,9 por cento) e Salmonella (3,4 por cento). A análise da qualidade da água empregada no sistema revelou, de um modo geral, índices mais elevados de coliformes fecais nos tanques dos peixes (>1800/100 ml).

The presence of bacterial enteropathogens from fishes of a nutrient recycle system from a Experimental Station in Petropolis, RJ, was evaluated in 72 samples from april 2000 to july 2001 Simultaneously was collected the mud used as organic manure and poultry beds localized next to the tanks. The isolation procedures included preenrichment in Peptone Water followed by enrichment with alcaline Peptone Water (pH 8.4-8.6), and streaked onto GSP Agar for the isolation of Aeromonas spp. and Plesiomonas shigelloides. For enteropathogenic bacteria of the Enterobacteriaceae family, 1ml samples were transferred for enrichment in Rappaport- Vassiladis broth and Kauffmann Tetrathionate Broth followed by streak onto Hektoen Enteric Agar and Salmonella-Shigella Agar. Simultaneously at each visit samples of water from fish and macrophyte tanks were collected for monitoring faecal coliforms (MPN) using A1 medium. Among the 116 isolates, Aeromonas spp. were the most frequent (67.2 percent) with 9 species (A. veronii, biogroup sobria, A. hidrophila, A. sobria, A. trota, A. eucrenophila, A. veronii biog. veronii, A. media, A. cavia and A. jandaei), followed by Edwardsiella tarda (16.4 percent), Plesiomonas shigelloides (12.9 percent) and Salmonella spp. (3.4 percent). The NMP of fecal coliforms showed higher values in the fish tanks (>1800/100ml).

Evaluation of virulence factors in environmental isolates of Vibrio species

Strains of Vibrio parahaemolyticus, Vibrio fluvialis and Vibrio mimicus isolated from seafood and seawater were examined for characteristics related to infectivity, such as enzymatic activity and animal assays. All strains hydrolysed DNA, starch, gelatin and chitin. Variable results were obtained with the haemolysin, chondroitin, collagen, elastin and lecithin tests. Production of thermostable direct haemolysin by V. parahaemolyticus was detected in 7.1 per cent strains derived from seafood and 2 per cent from seawater. In the animal assays, strains of V. fluvialis showed positive results at skin PF (75 per cent ), mouse lethality (100 per cent ), but no fluid accumulation in the suckling mice model was noted. Concerning V. mimicus, results showed skin PF (100 per cent ), mouse lethality (100 per cent ) and fluid accumulation in suckling mice (66.6 per cent )