백서에서 저체온 전처치가 환기기유발폐손상 억제에 미치는 효과

임채만; 홍상범; 고윤석; 심태선; 이상도; 김우성; 김동순; 김원동

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자료유형: 학술저널

저자정보: 임채만 (울산대학교 의과대학 서울중앙병원 내과학교실) 홍상범 (울산대학교 의과대학 서울중앙병원 내과학교실) 고윤석 (울산대학교 의과대학 서울중앙병원 내과학교실) 심태선 (울산대학교 의과대학 서울중앙병원 내과학교실) 이상도 (울산대학교 의과대학 서울중앙병원 내과학교실) 김우성 (울산대학교 의과대학 서울중앙병원 내과학교실) 김동순 (울산대학교 의과대학 서울중앙병원 내과학교실) 김원동 (울산대학교 의과대학 서울중앙병원 내과학교실)

저널정보: 대한결핵 및 호흡기학회 Tuberculosis and Respiratory Diseases 결핵 및 호흡기 질환 제50권 제5호

발행연도: 2001.1

수록면: 540 - 548 (9page)

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Backgrounds : Because ventilator-induced lung injury is partly dependent on the intensity of vascular flow, we hypothesized that hypothermia may attenuate the degree of such an injury through a reduced cardiac output. Methods : Twenty-seven male Sprague-Dawley rats were randomly assigned to normothermia ($37{\pm}1^{\circ}C$)-injurious ventilation (NT-V) group (n=10), hypothermia ($27{\pm}1^{\circ}C$)-injurious ventilation (HT-V) group (n=10), or nonventilated control group (n=7). The two thermal groups were subjected to injurious mechanical ventilation for 20 min with peak airway pressure 30 cm $H_2O$ at zero positive end-expiratory pressure, which was translated to tidal volume $54{\pm}6\;ml$ in the NT-V group and $53{\pm}4\;ml$ in the HT-V group (p>0.05). Results : Pressure-volume (P-V) curve after the injurious ventilation was almost identical to the baseline P-V curve in the HT-V group, whereas it was shifted rightward in the NT-V group. On gross inspection, the lungs of the HT-V group appeared smaller in size, and showed less hemorrhage especially at the dependent regions, than the lungs of the NT-V group. [Wet lung weight (g)/body weight (kg)] ($1.6{\pm}0.1$ vs $2.4{\pm}1.2$ ; p=0.014) and [wet lung weight/dry lung weight] ($5.0{\pm}0.1$ vs $6.1{\pm}0.8$ ; p=0.046) of the HT-V group were both lower than those of the NT-V group, while not different from those of the control group($1.4{\pm}0.4$, $4.8{\pm}0.4$, respectively). Protein concentration of the BAL fluid of the HT-V group was lower than that of the NT-V group($1,374{\pm}726\;ug/ml$ vs $3,471{\pm}1,985\;ug/ml$;p=0.003). Lactic dehydrogenase level of the BAL fluid of the HT-V group was lower than that of the NT-V group ($0.18{\pm}0.10\;unit/ml$ vs $0.43{\pm}0.22\;unit/ml$;p=0.046). Conclusions : Hypothermia attenuated pulmonary hemorrhage, permeability pulmonary edema, and alveolar cellular injuries associated with injurious mechanical ventilation, and preserved normal P-V characteristics of the lung in rats.

#Ventilator-induced lung injury #Hypothermia #Cardiac output #Pressure-volume curve #Alveolar hemorrhage #Permeability edema #Bronchalveolar lavage fluid

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