Lung and 'end organ' injury due to mechanical ventilation in animals: comparison between the prone and supine positions

Critical Care : the Official Journal of the Critical Care Forum
George NakosMaria Bai

Abstract

Use of the prone position in patients with acute lung injury improves their oxygenation. Most of these patients die from multisystem organ failure and not from hypoxia, however. Moreover, there is some evidence that the organ failure is caused by increased cell apoptosis. In the present study we therefore examined whether the position of the patients affects histological changes and apoptosis in the lung and 'end organs', including the brain, heart, diaphragm, liver, kidneys and small intestine. Ten mechanically ventilated sheep with a tidal volume of 15 ml/kg body weight were studied for 90 minutes. Five sheep were placed in the supine position and five sheep were placed in the prone position during the experiment. Lung changes were analyzed histologically using a semiquantitative scoring system and the extent of apoptosis was investigated with the TUNEL method. In the supine position intra-alveolar hemorrhage appeared predominantly in the dorsal areas, while the other histopathologic lesions were homogeneously distributed throughout the lungs. In the prone position, all histological changes were homogeneously distributed. A significantly higher score of lung injury was found in the supine position than in the prone position (...Continue Reading

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Citations

May 9, 2006·Critical Care : the Official Journal of the Critical Care Forum·Peter M Suter
Feb 23, 2007·Critical Care : the Official Journal of the Critical Care Forum·Maria-Eudóxia Pilotto de CarvalhoDaniel Deheinzelin
Sep 4, 2007·Critical Care : the Official Journal of the Critical Care Forum·Daniela VasquezNiall D Ferguson
Mar 20, 2010·Critical Care : the Official Journal of the Critical Care Forum·Paolo PelosiPatricia R M Rocco
Oct 17, 2006·Vojnosanitetski pregled. Military-medical and pharmaceutical review·Tatjana VulovićZoran Slavković
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May 7, 2016·World Journal of Critical Care Medicine·Vasilios KoulourasGeorgios Nakos
May 23, 2018·American Journal of Respiratory and Critical Care Medicine·Gabriel C Motta-RibeiroMarcos F Vidal Melo
Jan 25, 2008·Critical Care Medicine·Leonardo LorenteAlejandro Jiménez
Apr 26, 2007·Intensive Care Medicine·Leonardo LorenteMaría L Mora
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Jul 28, 2010·Expert Review of Respiratory Medicine·Patricia R M RoccoMarcelo Gama de Abreu

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Methods Mentioned

BETA
light microscopy

Software Mentioned

Statistical Package for Social Sciences ( SPSS )

Related Concepts

Related Feeds

Apoptosis

Apoptosis is a specific process that leads to programmed cell death through the activation of an evolutionary conserved intracellular pathway leading to pathognomic cellular changes distinct from cellular necrosis