Effect of Lung Protective Ventilation Strategies on Respiratory Function and Hemodynamics in Chronic Obstructive Pulmonary Disease(COPD)Rats
Objective:To investigate the effects of different tidal volumes and positive end-expiratory pressure(PEEP)lung protective ventilation strategies on respiratory function and hemodynamics in COPD rat models.Methods:COPD rat models were established by smoke inhalation and intratracheal administration of lipopolysaccharide(LPS).Rats were randomly divided into 9 groups(10 rats per group):control and COPD groups received tracheal intubation only without mechanical ventilation;L+P0 group,L+P3 group,L+P5 group,and L+P10 group received mechanical ventilation with 6 ml/kg tidal volume and 0 cm H2O,3 cm H2O,5 cm H2O,and 10 cm H2O PEEP,respectively,for 120 min after tracheal intubation;H+P0 group,H+P3 group,H+P5 group,and H+P10 group received mechanical ventilation with 20 ml/kg tidal volume and 0 cm H2O,3 cm H2O,5 cm H2O,and 10 cm H2O PEEP,respectively,for 120 min after tracheal intuba-tion.Respiratory function and hemodynamic parameters were measured using a small animal non-invasive re-spiratory function monitoring system and blood gas analyzer.Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of inflammatory mediators in lung tissue and bronchoalveolar lavage fluid(BALF).Results:Compared with the control group,COPD rats showed significantly decreased respiratory function parameters and PaO2(P<0.05);compared with the COPD group,L+P0 group,L+P3 group,and L+P5 group showed significantly increased respiratory function parameters and PaO2(P<0.05),while L+P10 group,H+P0 group,H+P3 group,H+P5 group,and H+P10 group showed significantly decreased respiratory function parameters and PaO2(P<0.05);L+P5 group showed significantly higher respiratory function parame-ters and PaO2 than L+P0 group and L+P3 group(P<0.05);compared with L+P5 group,L+P10 group,H+P0 group,H+P3 group,H+P5 group,and H+P10 group showed significantly decreased respiratory function parameters and PaO2(P<0.05).Compared with the control group,COPD rats showed significantly increased levels of IL-8 and TNF-α in lung tissue and BALF,while IL-10 levels were significantly decreased(P<0.05);compared with the COPD group,L+P0 group,L+P3 group,and L+P5 group showed significantly de-creased levels of IL-8 and TNF-α and significantly increased levels of IL-10(P<0.05),while L+P10 group,H+P0 group,H+P3 group,H+P5 group,and H+P10 group showed significantly increased levels of IL-8 and TNF-α and significantly decreased levels of IL-10(P<0.05);L+P5 group showed significantly lower levels of IL-8 and TNF-α in lung tissue and significantly higher levels of IL-10 than L+P0 group and L+P3 group(P<0.05);compared with L+P5 group,L+P10 group,H+P0 group,H+P3 group,H+P5 group,and H+P10 group showed significantly increased levels of IL-8 and TNF-α and significantly decreased levels of IL-10(P<0.05).Conclusion:Lung protective ventilation strategies with low tidal volume and high-er PEEP(such as 5 cm H2O PEEP)can alleviate lung inflammation and lung injury in COPD rats,improve respiratory function and hemodynamics in COPD patients.
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