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Departments of Physiology, Medicine, and Pathology, Lawson Health Research Institute, St. Joseph's Health Centre, University of Western Ontario, London, Ontario, Canada N6A 4V2
The effects of mechanical
ventilation (MV) on the surfactant system and cytokine secretion were
studied in isolated septic rat lungs. At 23 h after sham surgery
or induction of sepsis by cecal ligation and perforation (CLP), lungs
were excised and randomized to one of three groups: 1) a
nonventilated group, 2) a group subjected to 1 h of noninjurious
MV (tidal volume = 10 ml/kg, positive end-expiratory pressure = 3 cmH2O), or 3) a group subjected to 1 h
of injurious MV (tidal volume = 20 ml/kg, positive end-expiratory
pressure = 0 cmH2O). Nonventilated sham and CLP lungs
had similar compliance, normal lung morphology, surfactant, and
cytokine concentrations. Injurious ventilation decreased compliance,
altered surfactant, increased cytokines, and induced morphological
changes compared with nonventilation in sham and CLP lungs. In these
lungs, the surfactant system was similar in sham and CLP lungs;
however, tumor necrosis factor-
and interleukin-6 levels were
significantly higher in CLP lungs. We conclude that injurious
ventilation altered surfactant independent of sepsis and that the CLP
lungs were predisposed to the secretion of larger amounts of cytokines
because of ventilation.
cecal ligation and perforation; sepsis; pulmonary surfactant
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