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J Appl Physiol 107: 1472-1478, 2009. First published September 10, 2009; doi:10.1152/japplphysiol.00393.2009
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Protective mechanical ventilation does not exacerbate lung function impairment or lung inflammation following influenza A infection

Graeme R. Zosky, Vincenzo Cannizzaro, Zoltan Hantos, and Peter D. Sly

Division of Clinical Science, Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Subiaco, Western Australia, Australia

Submitted 15 April 2009 ; accepted in final form 4 September 2009

The degree to which mechanical ventilation induces ventilator-associated lung injury is dependent on the initial acute lung injury (ALI). Viral-induced ALI is poorly studied, and this study aimed to determine whether ALI induced by a clinically relevant infection is exacerbated by protective mechanical ventilation. Adult female BALB/c mice were inoculated with 104.5 plaque-forming units of influenza A/Mem/1/71 in 50 µl of medium or medium alone. This study used a protective ventilation strategy, whereby mice were anesthetized, tracheostomized, and mechanically ventilated for 2 h. Lung mechanics were measured periodically throughout the ventilation period using a modification of the forced oscillation technique to obtain measures of airway resistance and coefficients of tissue damping and tissue elastance. Thoracic gas volume was measured and used to obtain specific airway resistance, tissue damping, and tissue elastance. At the end of the ventilation period, a bronchoalveolar lavage sample was collected to measure inflammatory cells, macrophage inflammatory protein-2, IL-6, TNF-{alpha}, and protein leak. Influenza infection caused significant increases in inflammatory cells, protein leak, and deterioration in lung mechanics that were not exacerbated by mechanical ventilation, in contrast to previous studies using bacterial and mouse-specific viral infection. This study highlighted the importance of type and severity of lung injury in determining outcome following mechanical ventilation.

ventilator-associated lung injury; viral infection; BALB/c



Address for reprint requests and other correspondence: G. R. Zosky, Division of Clinical Sciences, Telethon Institute for Child Health Research, 100 Roberts Rd., Subiaco, Western Australia 6008, Australia (e-mail: graemez{at}ichr.uwa.edu.au).







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