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Mild hypothermia attenuate kidney injury in canines with oleic acid-induced acute respiratory distress syndrome
Affiliation:1. Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, PR China;2. Beijing Institute of Respiratory Medicine, Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China;1. KU Leuven – University of Leuven, Faculty of Medicine, B-3000 Leuven, Belgium;2. University Hospitals Leuven, Department of Trauma Surgery, B-3000 Leuven, Belgium;3. University Hospitals Leuven, Care Program Management, B-3000 Leuven, Belgium;4. KU Leuven – University of Leuven, Department of Development and Regeneration, B-3000 Leuven, Belgium;1. Ilizarov Unit S.C Ortopedia e Traumatologia, Manzoni Hospital, Lecco, Italy;2. Department of Orthopedic and Trauma, Postgraduate Medical Institute Hayatabad, Medical Complex, Peshawar, Pakistan;1. Department of Orthopaedic Sugery, Guro Hospital, College of Medicine, Korea University, Seoul, Korea;2. Department of Orthopaedic Sugery, Ansan Hospital, College of Medicine, Korea University, Gyeonggido, Korea;3. Department of Radiology, Guro Hospital, College of Medicine, Korea University, Seoul, Korea;1. Service d’Anesthésie-Réanimation, Hôpital Européen Georges Pompidou, Université Paris 5 Descartes, Sorbonne Paris Cite, Paris, France;2. Department of Anesthesia and Perioperative Care, San Francisco General Hospital and Trauma Center, University of California San Francisco, San Francisco, USA;3. Département de Biostatistique et Informatique Médicale, INSERM U1153, équipe ECSTRA, Hôpital Saint Louis, Université Paris Diderot, Sorbonne Paris Cite, Paris, France;4. SAMU 92, Hôpital Raymond Poincare, Université de Versailles St Quentin, Garches, France;5. Division of Biostatistics, School of Public Health, University of California Berkeley, Berkeley, USA;1. The Orthopaedic Trauma Unit, Division of Orthopaedics, University of Alabama at Birmingham, United States;2. Talpiot Medical Leadership Program, Sheba Medical Centre, Israel
Abstract:BackgroundHypothermia may attenuate ventilator induced-lung injury in acute respiratory distress syndrome (ARDS). However, the impact of hypothermia on extra-pulmonary organ injury in ARDS remains unclear. The purpose of this study was to investigate whether hypothermia affects extra-pulmonary organ injury in a canine ARDS model induced by oleic acid.ObjectivesTwelve anesthetized canines with oleic acid-induced ARDS were randomly divided (n = 6 per group) into a hypothermia group (core temperature of 33 ± 1 °C, HT group) and a normothermia group (core temperature of 38 ± 1 °C, NT group) and treated for four hours. The liver, small intestine and kidney were assessed by evaluating biochemical parameters, plasma and tissue cytokine levels, and tissue histopathological injury scores.ResultsThe HT group showed a lower plateau pressure, lung elastance and pulmonary vascular resistance. Hypothermia was associated with lower oxygen consumption (138.4 ± 55.0 ml min−1 vs. 72.0 ± 11.2 ml min−1, P < 0.05) and higher oxygen saturation of mixed venous blood (62.8% ± 8.0% vs. 77.5% ± 10.1%, P < 0.05). Both groups had similar levels of tumour necrosis factor-α in the plasma and extra-pulmonary organ, however, plasma interleukin-10 (97.1 ± 25.0 pg ml−1 vs. 131.4 ± 27.0 pg ml−1, P < 0.05) was higher in the HT group. Further, the animals in the HT group had a lower levels of plasma creatinine (54.6 ± 19.1 U L−1 vs. 29.1 ± 8.0 U L−1, P < 0.05), and lower renal histopathological injury scores [4.0(3.5;7.0) vs. 1.5(0.8;3.0), P < 0.05]. Hypothermia did not affect the histopathological injury of the liver and small intestine.ConclusionsShort-term mild hypothermia can reduce lung elastance and pulmonary vascular resistance, increase the systemic anti-inflammatory response and attenuate kidney histopathological injury in a canine ARDS model induced by oleic acid.
Keywords:Hypothermia  Acute respiratory distress syndrome  Ventilator induced-lung injury  Mechanical ventilation  Multiple organs failure  Kidney injury
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