Saudi Journal of Anaesthesia

ORIGINAL ARTICLE
Year
: 2021  |  Volume : 15  |  Issue : 1  |  Page : 1--6

The effect of low versus high tidal volume ventilation on inflammatory markers in animal model undergoing lung ventilation: A prospective study


Waseem M Hajjar1, Abdelazeem Eldawlatly2, Sami A Alnassar1, Iftikhar Ahmed1, Alaa Alghamedi1, Zahid Shakoor3, Ammar C Alrikabi3, Adnan W Hajjar1, Abdulaziz Ejaz Ahmad2 
1 Department of Surgery, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
2 Department of Anesthesia, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
3 Department of Pathology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia

Correspondence Address:
Dr. Waseem M Hajjar
Department of Surgery, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, P.O.BOX 7805, Riyadh 11472
Kingdom of Saudi Arabia

Background and Aims: Mechanical ventilation (MV) with high tidal volume (Vt.) may induce or aggravate lung injury in critically ill patients. It might also cause an overwhelming systemic inflammation leading to acute lung injury (ALI), diffuse alveolar damage (DAD) and multiple organ failure (MOF) with subsequent high mortality. The objective of this study was to compare the effects of different Vt. on the inflammatory markers of the broncho-alveolar lavage (BAL) fluid and lung biopsy in a group of animal model (Beagle dogs). Methods: A two-phased prospective study involving 30 Beagle dogs (15 dogs/phase), each phase divided into three groups (each 5 dogs/group). In the first phase each group received MV with Vt. of 8 (low), 10 (normal, control group), and 12 (high) ml/kg body weight (b.w.) respectively. BAL fluid was obtained at the time of induction of anesthesia immediately following tracheal intubation and one hour later following MV to count the macrophages, neutrophils and lymphocytes. In the second phase of the experiment, in addition to obtaining (BAL) fluid similar to the phase one, mini thoracotomy and lung biopsy obtained from the upper lobe of the right lung at same timings for histopathological examination study. Mann-Whitney-Wilcoxon test was used for statistical analysis of the data obtained. Results: BAL fluid analysis showed increase in the counts of macrophages and lymphocytes with Vt. of 12 ml/kg b.w. compared to the control group (10 ml/kg b.w.) (P < 0.05). in the second phase, similar findings obtained. The histopathological study of the lung tissue obtained in the second phase of the study from the group that received a high Vt. of 12 ml/kg b.w. showed significant inflammatory changes with presence of neutrophil infiltration and edema in the bronchial wall compared to the control group (10 ml/kg b.w.) (P < 0.05). Conclusions: The use of high Vt. in ventilated animal lung model may increase the risk of inflammation and subsequent damage in healthy lungs, these findings may help physicians to avoid using high Vt. in short-term mechanically ventilated patients in the operating room setting.


How to cite this article:
Hajjar WM, Eldawlatly A, Alnassar SA, Ahmed I, Alghamedi A, Shakoor Z, Alrikabi AC, Hajjar AW, Ahmad AE. The effect of low versus high tidal volume ventilation on inflammatory markers in animal model undergoing lung ventilation: A prospective study.Saudi J Anaesth 2021;15:1-6


How to cite this URL:
Hajjar WM, Eldawlatly A, Alnassar SA, Ahmed I, Alghamedi A, Shakoor Z, Alrikabi AC, Hajjar AW, Ahmad AE. The effect of low versus high tidal volume ventilation on inflammatory markers in animal model undergoing lung ventilation: A prospective study. Saudi J Anaesth [serial online] 2021 [cited 2021 Jan 28 ];15:1-6
Available from: https://www.saudija.org/article.asp?issn=1658-354X;year=2021;volume=15;issue=1;spage=1;epage=6;aulast=Hajjar;type=0