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• W2155495967 abstract "<h3>BACKGROUND:</h3> The combination of high PEEP and low tidal volume (V_T) decreases some risks of mechanical ventilation, including pulmonary overdistention, damage due to cyclic opening and closing of the alveoli, and inflammatory responses that can lead to multiple-organ dysfunction. We hypothesized that high V_T and high PEEP induce mesenteric microcirculatory disturbances and that those disturbances would be attenuated by pentoxifylline, which is anti-inflammatory. <h3>METHODS:</h3> We anesthetized (isoflurane 1.5%), tracheostomized, and mechanically ventilated 57 male Wistar rats with PEEP of 10 cm H₂O and F_IO₂ of 0.21 for 2 hours. One group received low V_T (7 mL/kg), another group received high V_T (10 mL/kg), and a third group received high V_T plus pentoxifylline (25 mg/kg). We measured mean arterial pressure, respiratory mechanics, mesenteric blood flow, and leukocyte-endothelial interactions. <h3>RESULTS:</h3> The mean arterial pressure was similar among the groups at baseline (108 mm Hg [IQR 94–118 mm Hg]) and after 2 hours of mechanical ventilation (104 mm Hg [IQR 90–114 mm Hg]). Mesenteric blood flow was also similar between the groups: low V_T 15.1 mL/min (IQR 12.4–17.7 mL/min), high V_T 11.3 mL/min (IQR 8.6–13.8 mL/min), high-V_T/pentoxifylline 12.4 mL/min (10.8–13.7 mL/min). Peak airway pressure after 2 hours was lower (<i>P</i> = .03) in the low-V_T group (10.4 cm H₂O [IQR 10.2–10.4 cm H₂O]) than in the high-V_T group (12.6 cm H₂O [10.2–14.9 cm H₂O]) or the high-V_T/pentoxifylline group (12.8 cm H₂O [10.7–16.0 cm H₂O]). There were fewer adherent leukocytes (<i>P</i> = .005) and fewer migrated leukocytes (<i>P</i> = .002) in the low-V_T group (5 cells/100 μm length [IQR 4–7 cells/100 μm length] and 1 cell/5,000 μm² [IQR 1–2 cells/5,000 μm²], respectively) and the high-V_T/pentoxifylline group (5 cells/100 μm length [IQR 3–10 cells/100 μm length] and 1 cell/5,000 μm² [IQR 1–3 cells/5,000 μm²], respectively) than in the high-V_T group (14 cells/100 μm length [IQR 11–16 cells/100 μm length] and 9 cells/5,000 μm² [IQR 8–12 cells/5,000 μm²], respectively). <h3>CONCLUSIONS:</h3> Low V_T with high PEEP was lung-protective, and early pentoxifylline reduced the inflammatory response to high V_T with high PEEP (and presumed lung overdistention) during mechanical ventilation." @default.
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• W2155495967 title "Association of 1078 del T cystic fibrosis mutation with severe disease." @default.
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• W2155495967 doi "https://doi.org/10.1136/jmg.31.2.159" @default.
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