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Effects of body temperature on ventilator-induced lung injury
Authors:Akinci Ozkan I  Celik Mehmet  Mutlu Gökhan M  Martino Janice M  Tugrul Simru  Ozcan Perihan E  Yilmazbayhan Dilek  Yeldandi Anjana V  Turkoz Kemal H  Kiran Bayram  Telci Lütfi  Cakar Nahit
Affiliation:Department of Anesthesiology and Intensive Care, Istanbul Medical Faculty, Capa, Turkey. iozkana@yahoo.com
Abstract:PURPOSE: To evaluate the effects of body temperature on ventilator-induced lung injury. MATERIAL AND METHODS: Thirty-four male Sprague-Dawley rats were randomized into 6 groups based on their body temperature (normothermia, 37 +/- 1 degrees C; hypothermia, 31 +/- 1 degrees C; hyperthermia, 41 +/- 1 degrees C). Ventilator-induced lung injury was achieved by ventilating for 1 hour with pressure-controlled ventilation mode set at peak inspiratory pressure (PIP) of 30 cmH2O (high pressure, or HP) and positive end-expiratory pressure (PEEP) of 0 cmH2O. In control subjects, PIP was set at 14 cmH2O (low pressure, or LP) and PEEP set at 0 cmH2O. Systemic chemokine and cytokine (tumor necrosis factor alpha , interleukin 1 beta , interleukin 6, and monocyte chemoattractant protein 1) levels were measured. The lungs were assessed for histological changes. RESULTS: Serum chemokines and cytokines were significantly elevated in the hyperthermia HP group compared with all 3 groups, LP (control), normothermia HP, and hypothermia HP. Oxygenation was better but not statistically significant in hypothermia HP compared with other HP groups. Cumulative mean histology scores were higher in hyperthermia HP and normothermia HP groups compared with control and normothermia HP groups. CONCLUSIONS: Concomitant hyperthermia increased systemic inflammatory response during HP ventilation. Although hypothermia decreased local inflammation in the lung, it did not completely attenuate systemic inflammatory response associated with HP ventilation.
Keywords:Hyperthermia   Hypothermia   Mechanical ventilation   Cytokines   Ventilator-induced lung injury
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