Application of the open-lung concept during positive-pressure ventilation reduces pulmonary inflammation in newborn piglets

• Published in: Biology of the neonate Vol. 83; no. 4; pp. 273 - 280
• Main Authors: VAN KAAM, Anton H, DIK, Willem A, HAITSMA, Jack J, DE JAEGERE, Anne, NABER, Birgitta A, VAN AALDEREN, Wim M, KOK, Joke H, LACHMANN, Burkhard
• Format: Journal Article
• Language: English
• Published: Basel Karger 01.01.2003; S. Karger AG
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Animals; Animals, Newborn; Biological and medical sciences; Bronchoalveolar Lavage Fluid - chemistry; Bronchoalveolar Lavage Fluid - cytology; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Intensive care medicine; Interleukin-8 - analysis; Leukocyte Count; Medical sciences; Neutrophils; Pneumonia - prevention & control; Positive-Pressure Respiration - methods; Swine; Thrombin - analysis; Tumor Necrosis Factor-alpha - analysis; Human; Pulmonary inflammation; Cytokines; Lung; Inflammation; Open-lung concept; Respiratory system; High-frequency oscillatory ventilation; Pig; Vertebrata; Mammalia; Newborn; Positive pressure; Intermittent positive-pressure ventilation; Animal; Artiodactyla; Pulmonary ventilation; Newborn piglets; Respiration; Ungulata
• ISSN: 0006-3126; 1661-7800; 1421-9727; 1661-7819
• DOI: 10.1159/000069482

It has been shown that application of the open-lung concept (OLC) during high-frequency oscillatory ventilation (HFOV) attenuates pulmonary inflammation. We hypothesized that this attenuation could also be achieved by applying the OLC during positive-pressure ventilation (PPV). After repeated whole-lung lavage, newborn piglets were assigned to one of three ventilation groups: (1) PPV(OLC); (2) HFOV(OLC), or (3) conventional PPV (PPV(CON)). After a ventilation period of 5 h, analysis of bronchoalveolar lavage fluid showed a reduced influx of polymorphonuclear neutrophils, interleukin 8, and thrombin activity in both OLC groups as compared with the PPV(CON) group. There were no differences in tumor necrosis factor alpha levels. We conclude that application of the OLC during PPV reduces pulmonary inflammation as compared with conventional PPV and that the magnitude of this reduction is comparable to that of HFOV.