Prone positioning attenuates TNF-alpha production in rabbits with lung injury under protective conventional mechanical ventilation (CMV).
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1
Botucatu Medical School - São Paulo State University - UNESP, Brazil
1Cilmery Suemi Kurokawa, 1Rafaelle Batistella Pires, 1Jose Roberto Fioretto, 1Susiane O Klefens, 2João Pessoa de Araujo Júnior, 1Marcos Aurelio de Moraes, 1Ana Paula Mena Lousada, 1Rossano Cesar Bonatto, 1Mario Ferreira Carpi. 1Department of Pediatrics and Department of 2Microbiology and Immunology, Botucatu Medical School - Sao Paulo State University – UNESP.
Prone positioning (PP) improves arterial oxygenation, gas exchange, distribution of ventilation toward dorsal lung areas, redirection of compressive forces on lung and facilitates secretion clearance in patients with ADRS. However, the exact mechanics of PP is still under investigation. The aim of this study aims was to measure TNF-alpha levels in rabbits with experimental ARDS under CMV and PP.
Methods: Rabbits were anesthetized, intubated and assigned into three groups: 1) Control Group(CG)– animals without lung injury under CMV in supine position; 2) Prone Group (PG)– animals with lung injury under CMV in prone position; 3) Supine Group (SG)- animals with lung injury under CMV in supine position. Lung injury was induced by tracheal infusion of warm saline. The parameters evaluated were: TNF-alpha in homogenate of lung tissue, bronchoalveolar fluid (BAL) and plasma; histological and cytological analysis of lung tissue and BAL, respectively. Results: Lung injury decreased oxygenation { PaO2 - PG before[median (p25-p75)]: 451 (412- 504) > PG after: 67 (59-76), p<0,05; PaO2 - SG before: 447 (401-503) > SG after: 76 (59-87); p<0,05}. PG group had lower level of TNF-alpha in tissue than supine group {PG[median (p25-p75)]: 7,2 (3,5-11,07) > SG: 24,1 (8,1-55,55); p<0,05}. There is no difference of serum and BAL TNF-alpha levels, histopathological lung injury score and BAL neutrophil percentage between PG and SG. Conclusions: Prone positioning with CMV decreased TNF-alpha production in lung tissue in this experimental model.
Acknowledgements
This study was supported by FAPESP (Fundação de Amparo a Pesquisa do EStado de São Paulo), process number 2011/15144-2. We would like to thank the whole team at the PICU and Clinical and Experimental Research Center of Pediatrics Department .
Keywords:
lung lesion,
tNF-alpha,
Cytokines,
mechnical ventilation,
Neutrophils
Conference:
15th International Congress of Immunology (ICI), Milan, Italy, 22 Aug - 27 Aug, 2013.
Presentation Type:
Abstract
Topic:
Innate immunity
Citation:
Kurokawa
CS
(2013). Prone positioning attenuates TNF-alpha production in rabbits with lung injury under protective conventional mechanical ventilation (CMV)..
Front. Immunol.
Conference Abstract:
15th International Congress of Immunology (ICI).
doi: 10.3389/conf.fimmu.2013.02.00141
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Received:
09 Mar 2013;
Published Online:
22 Aug 2013.
*
Correspondence:
Dr. Cilmery S Kurokawa, Botucatu Medical School - São Paulo State University - UNESP, Botucatu, Brazil, cskurokawa@gmail.com