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Atelectasis Induced by Thoracotomy Causes Lung Injury during Mechanical Ventilation in Endotoxemic Rats

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Author(s)
Won-Il ChoiKun Young KwonJin Mo KimDeborah A. QuinnCharles A. HalesJeong Wook Seo
Keimyung Author(s)
Kwon, Kun YoungKim, Jin MoChoi, Won Il
Department
Dept. of Pathology (병리학)
Dept. of Anesthesiology & Pain Medicine (마취통증의학)
Dept. of Internal Medicine (내과학)
Journal Title
Journal of Korean Medical Science
Issued Date
2008
Volume
23
Issue
3
Keyword
AtelectasisFunctional Residual CapacityLung InjuryNitric Oxide SynthaseNitric Oxide Synthase Inhibitor
Abstract
Atelectasis can impair arterial oxygenation and decrease lung compliance. However,
the effects of atelectasis on endotoxemic lungs during ventilation have not been well
studied. We hypothesized that ventilation at low volumes below functional residual
capacity (FRC) would accentuate lung injury in lipopolysaccharide (LPS)-pretreated
rats. LPS-pretreated rats were ventilated with room air at 85 breaths/min for 2 hr
at a tidal volume of 10 mL/kg with or without thoracotomy. Positive end-expiratory
pressure (PEEP) was applied to restore FRC in the thoracotomy group. While LPS
or thoracotomy alone did not cause significant injury, the combination of endotoxemia
and thoracotomy caused significant hypoxemia and hypercapnia. The injury
was observed along with a marked accumulation of inflammatory cells in the interstitium
of the lungs, predominantly comprising neutrophils and mononuclear cells.
Immunohistochemistry showed increased inducible nitric oxide synthase (iNOS)
expression in mononuclear cells accumulated in the interstitium in the injury group.
Pretreatment with PEEP or an iNOS inhibitor (1400 W) attenuated hypoxemia, hypercapnia,
and the accumulation of inflammatory cells in the lung. In conclusion, the
data suggest that atelectasis induced by thoracotomy causes lung injury during
mechanical ventilation in endotoxemic rats through iNOS expression.
Keimyung Author(s)(Kor)
권건영
김진모
최원일
Publisher
School of Medicine
Citation
Won-Il Choi et al. (2008). Atelectasis Induced by Thoracotomy Causes Lung Injury during Mechanical Ventilation in Endotoxemic Rats. Journal of Korean Medical Science, 23(3), 406–413. doi: 10.3346/jkms.2008.23.3.406
Type
Article
ISSN
1011-8934
DOI
10.3346/jkms.2008.23.3.406
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/34089
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Anesthesiology & Pain Medicine (마취통증의학)
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
1. School of Medicine (의과대학) > Dept. of Pathology (병리학)
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