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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Mechanical ventilation with high tidal volume induces inflammation in patients without lung disease. | Pinheiro de Oliveira et al. Critical Care 2010 14 R39 http ccforum.eom content 14 2 R39 c CRITICAL CARE RESEARCH Open Access Mechanical ventilation with high tidal volume induces inflammation in patients without lung disease 1.2 1 1 1 Roselaine Pinheiro de Oliveira Marcio Pereira Hetzel Mauro dos Anjos Silva Daniele Dallegrave Gilberto Friedman1 2 Abstract Introduction Mechanical ventilation MV with high tidal volumes may induce or aggravate lung injury in critical ill patients. We compared the effects of a protective versus a conventional ventilatory strategy on systemic and lung production of tumor necrosis factor-a TNF-a and interleukin-8 IL-8 in patients without lung disease. Methods Patients without lung disease and submitted to mechanical ventilation admitted to one trauma and one general adult intensive care unit of two different university hospitals were enrolled in a prospective randomized-control study. Patients were randomized to receive MV either with tidal volume VT of 10 to 12 ml kg predicted body weight high VT group n 10 or with VT of 5 to 7 ml kg predicted body weight low VT group n 10 with an oxygen inspiratory fraction FIO2 enough to keep arterial oxygen saturation 90 with positive end-expiratory pressure PEEP of 5 cmH2O during 12 hours after admission to the study. TNF-a and IL-8 concentrations were measured in the serum and in the bronchoalveolar lavage fluid BALF at admission and after 12 hours of study observation time. Results Twenty patients were enrolled and analyzed. At admission or after 12 hours there were no differences in serum TNF-a and IL-8 between the two groups. While initial analysis did not reveal significant differences standardization against urea of logarithmic transformed data revealed that TNF-a and IL-8 levels in bronchoalveolar lavage BAL fluid were stable in the low VT group but increased in the high VT group P 0.04 and P 0.03 . After 12 hours BALF TNF-a P 0.03 and BALF IL-8 concentrations P 0.03 were higher in the high
