Time course of haemodynamic, respiratory and inflammatory disturbances induced by experimental acute pulmonary polystyrene microembolism


Autoria(s): DOLCI, Daniel T.; FUENTES, Carolina B.; ROLIM, Denise; PARK, Marcelo; SCHETTINO, Guilherme P. P.; AZEVEDO, Luciano C. P.
Contribuinte(s)

UNIVERSIDADE DE SÃO PAULO

Data(s)

19/10/2012

19/10/2012

2010

Resumo

Background and objective The time course of cardiopulmonary alterations after pulmonary embolism has not been clearly demonstrated and nor has the role of systemic inflammation on the pathogenesis of the disease. This study aimed to evaluate over 12 h the effects of pulmonary embolism caused by polystyrene microspheres on the haemodynamics, lung mechanics and gas exchange and on interleukin-6 production. Methods Ten large white pigs (weight 35-42 kg) had arterial and pulmonary catheters inserted and pulmonary embolism was induced in five pigs by injection of polystyrene microspheres (diameter similar to 300 mu mol l(-1)) until a value of pulmonary mean arterial pressure of twice the baseline was obtained. Five other animals received only saline. Haemodynamic and respiratory data and pressure-volume curves of the respiratory system were collected. A bronchoscopy was performed before and 12 h after embolism, when the animals were euthanized. Results The embolism group developed hypoxaemia that was not corrected with high oxygen fractions, as well as higher values of dead space, airway resistance and lower respiratory compliance levels. Acute haemodynamic alterations included pulmonary arterial hypertension with preserved systemic arterial pressure and cardiac index. These derangements persisted until the end of the experiments. The plasma interleukin-6 concentrations were similar in both groups; however, an increase in core temperature and a nonsignificant higher concentration of bronchoalveolar lavage proteins were found in the embolism group. Conclusion Acute pulmonary embolism induced by polystyrene microspheres in pigs produces a 12-h lasting hypoxaemia and a high dead space associated with high airway resistance and low compliance. There were no plasma systemic markers of inflammation, but a higher central temperature and a trend towards higher bronchoalveolar lavage proteins were found. Eur J Anaesthesiol 27:67-76 (C) 2010 European Society of Anaesthesiology.

Research and Education Institute, Hospital Sirio-Libanes, Sao Paulo, Brazil

Identificador

EUROPEAN JOURNAL OF ANAESTHESIOLOGY, v.27, n.1, p.67-76, 2010

0265-0215

http://producao.usp.br/handle/BDPI/23153

10.1097/EJA.0b013e32832bfd7e

http://dx.doi.org/10.1097/EJA.0b013e32832bfd7e

Idioma(s)

eng

Publicador

LIPPINCOTT WILLIAMS & WILKINS

Relação

European Journal of Anaesthesiology

Direitos

closedAccess

Copyright LIPPINCOTT WILLIAMS & WILKINS

Palavras-Chave #animal model #haemodynamics #polystyrene microspheres #pulmonary embolism #respiratory physiology #GAS-EXCHANGE #EMBOLISM #THROMBOEMBOLISM #MECHANICS #CONTRACTILITY #HYPOXEMIA #PRESSURE #MODEL #DOGS #Anesthesiology
Tipo

article

original article

publishedVersion