Purpose: Hemorrhagic shock and resuscitation is frequently associated with liver ischemia-reperfusion injury. The aim of the study was to investigate whether hypoxemic resuscitation attenuates liver injury.
Methods: Anesthetized, mechanically ventilated New Zealand white rabbits were exsanguinated to a mean arterial pressure of 30 mmHg for 60 minutes. Resuscitation under normoxemia (Normox-Res group, n = 16, PaO(2) = 95-105 mmHg) or hypoxemia (Hypox-Res group, n = 15, PaO(2) = 35-40 mmHg) followed, modifying the FiO(2). Animals not subjected to shock constituted the sham group (n = 11, PaO(2) = 95-105 mmHg). Indices of the inflammatory, oxidative and nitrosative response were measured and histopathological and immunohistochemical studies of the liver were performed.
Results: Normox-Res group animals exhibited increased serum alanine aminotransferase, tumor necrosis factor--alpha, interleukin (IL) -1β and IL-6 levels compared with Hypox-Res and sham groups. Reactive oxygen species generation, malondialdehyde formation and myeloperoxidase activity were all elevated in Normox-Res rabbits compared with Hypox-Res and sham groups. Similarly, endothelial NO synthase and inducible NO synthase mRNA expression was up-regulated and nitrotyrosine immunostaining increased in animals resuscitated normoxemically, indicating a more intense nitrosative stress. Hypox-Res animals demonstrated a less prominent histopathologic injury which was similar to sham animals.
Conclusions: Hypoxemic resuscitation prevents liver reperfusion injury through attenuation of the inflammatory response and oxidative and nitrosative stresses.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3293918 | PMC |
| http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0032968 | PLOS |
Publication Analysis
Top Keywords
Similar Publications
Methods for determining optimal positive end-expiratory pressure in patients undergoing invasive mechanical ventilation: a scoping review.
Can J Anaesth
November 2024
Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada.
Purpose: There is significant variability in the application of positive end-expiratory pressure (PEEP) in patients undergoing invasive mechanical ventilation. There are numerous studies assessing methods of determining optimal PEEP, but many methods, patient populations, and study settings lack high-quality evidence. Guidelines make no recommendations about the use of a specific method because of equipoise and lack of high-quality evidence.
View Article and Find Full Text PDFEarly physiologic changes after awake prone positioning predict clinical outcomes in patients with acute hypoxemic respiratory failure.
Intensive Care Med
December 2024
Department of Medicine, Interdepartmental Division of Critical Care Medicine, Sinai Health System and University Health Network, University of Toronto, Toronto, Canada.
Purpose: The optimal physiologic parameters to monitor after a session of awake prone positioning in patients with acute respiratory failure are not well understood. This study aimed to identify which early physiologic changes after the first session of awake prone positioning are linked to the need for invasive mechanical ventilation or death in patients with acute respiratory failure.
Methods: We performed a secondary analysis of a prospective cohort study of adult patients with acute respiratory failure related to coronavirus disease 2019 (COVID-19) treated with awake prone positioning.
Complex end-of-life decision-making during neonatal retrieval: A retrospective cohort study.
J Paediatr Child Health
December 2024
NeoRESQ, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
Article Synopsis
- The study aimed to compare two groups of infants: those who received palliative care before being transferred to a retrieval service and those who were transferred and then received palliative care within 7 days of birth.
- A retrospective review was conducted on data from 60 infants referred to the service, focusing on their clinical needs and outcomes based on their palliative care timing.
- Results showed infants who were palliated at the referring hospital tended to require more intensive interventions before transport, suggesting that palliative care earlier in the process may be beneficial when further treatment is unlikely to improve outcomes.
Impact of mechanical power on ICU mortality in ventilated critically ill patients: a retrospective study with continuous real-life data.
Eur J Med Res
October 2024
Critical Care Department, Hospital Universitario Joan XXIII, Mallafré Guasch 4, 43005, Tarragona, Spain.
Article Synopsis
- Over the last decade, research has focused on how mechanical power contributes to ventilation-induced lung injury and its potential link to ICU mortality, but most studies have only looked at early mechanical ventilation data.
- This study analyzed mechanical power in patients ventilated for over 24 hours in a Spanish ICU, determining how prolonged exposure to high mechanical power impacts mortality rates and hospital stay duration.
- Researchers established that a mechanical power threshold of 18 J/min significantly correlates with increased ICU mortality; specifically, the risk of death rises by 0.1% for each additional hour patients are ventilated above this threshold.
Derivation and validation of generalized sepsis-induced acute respiratory failure phenotypes among critically ill patients: a retrospective study.
Crit Care
October 2024
Department of Surgery, Duke University School of Medicine, Durham, NC, 27707, USA.
Article Synopsis
- Researchers studied septic patients with acute respiratory failure (ARF) needing mechanical ventilation to identify different patient phenotypes, aiming to understand the variability in their clinical presentation and outcomes.
- They conducted a multi-center retrospective study, analyzing clinical data from ICU patients across two hospitals and using machine learning to cluster the data into distinct phenotypes.
- Four phenotypes were identified, each displaying unique clinical features and mortality outcomes, demonstrating significant differences in 28-day mortality rates among them despite similar demographics.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!