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Vol. 84, Issue 4, 1113-1118, April 1998
Departments of Physiology and Pathology, University of South Alabama, Mobile, Alabama 36688
To determine the
initial signaling event in the vascular permeability increase after
high airway pressure injury, we compared groups of lungs ventilated at
different peak inflation pressures (PIPs) with (gadolinium group) and
without (control group) infusion of 20 µM gadolinium chloride, an
inhibitor of endothelial stretch-activated cation
channels. Microvascular permeability was assessed by using the capillary filtration coefficient
(Kfc), a
measure of capillary hydraulic conductivity.
Kfc was measured
after ventilation for 30-min periods with 7, 20, and 30 cmH2O PIP with 3 cmH2O positive end-expiratory
pressure and with 35 cmH2O PIP
with 8 cmH2O positive end-expiratory pressure. In control lungs,
Kfc increased
significantly to 1.8 and 3.7 times baseline after 30 and 35 cmH2O PIP, respectively. In the
gadolinium group,
Kfc was unchanged
from baseline (0.060 ± 0.010 ml · min
1 · cmH2O
1 · 100 g
1) after any PIP
ventilation period. Pulmonary vascular resistance increased
significantly from baseline in both groups before the last
Kfc measurement
but was not different between groups. These results suggest that
microvascular permeability is actively modulated by a cellular response
to mechanical injury and that stretch-activated cation channels may
initiate this response through increases in intracellular calcium
concentration.
pulmonary barotrauma; pulmonary edema; mechanical ventilation; capillary filtration coefficient; gadolinium chloride
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