Journal article
Inflammatory Activity in Atelectatic and Normally Aerated Regions During Early Acute Lung Injury
Academic radiology, Vol.27(12), pp.1679-1690
12/01/2020
DOI: 10.1016/j.acra.2019.12.022
PMID: 32173290
Abstract
Rationale and Objectives: Pulmonary atelectasis presumably promotes and facilitates lung injury. However, data are limited on its direct and remote relation to inflammation. We aimed to assess regional 2-deoxy-2-[F-18]-fluoro-D-glucose (F-18-FDG) kinetics representative of inflammation in atelectatic and normally aerated regions in models of early lung injury.
Materials and Methods: We studied supine sheep in four groups: Permissive Atelectasis (n = 6)-16 hours protective tidal volume (VT) and zero positive end-expiratory pressure; Mild (n = 5) and Moderate Endotoxemia (n = 6)- 20-24 hours protective ventilation and intravenous lipopolysaccharide (Mild = 2.5 and Moderate = 10.0 ng/kg/min), and Surfactant Depletion (n = 6)-saline lung lavage and 4 hours high V-T. Measurements performed immediately after anesthesia induction served as controls (n = 8). Atelectasis was defined as regions of gas fraction <0.1 in transmission or computed tomography scans. F-18-FDG kinetics measured with positron emission tomography were analyzed with a three-compartment model.
Results: F-18-FDG net uptake rate in atelectatic tissue was larger during Moderate Endotoxemia (0.0092 +/- 0.0019/min) than controls (0.0051 +/- 0.0014/min, p = 0.01). F-18-FDG phosphorylation rate in atelectatic tissue was larger in both endotoxemia groups (0.0287 +/- 0.0075/min) than controls (0.0198 +/- 0.0039/min, p = 0.05) while the F-18-FDG volume of distribution was not significantly different among groups. Additionally, normally aerated regions showed larger F-18-FDG uptake during Permissive Atelectasis (0.0031 +/- 0.0005/min, p < 0.01), Mild 0.0028 +/- 0.0006/min, p = 0.04), and Moderate Endotoxemia (0.0039 +/- 0.0005/min, p < 0.01) than controls (0.0020 +/- 0.0003/min).
Conclusion: Atelectatic regions present increased metabolic activation during moderate endotoxemia mostly due to increased F-18-FDG phosphorylation, indicative of increased cellular metabolic activation. Increased F-18-FDG uptake in normally aerated regions during permissive atelectasis suggests an injurious remote effect of atelectasis even with protective tidal volumes.
Details
- Title: Subtitle
- Inflammatory Activity in Atelectatic and Normally Aerated Regions During Early Acute Lung Injury
- Creators
- Takuga Hinoshita - Massachusetts General HospitalGabriel Motta Ribeiro - Universidade de São PauloTilo Winkler - Massachusetts General HospitalNicolas de Prost - Hôpitaux Universitaires Henri-MondorMauro R. Tucci - Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloEduardo Leite Vieira Costa - Hosp Clin Sao Paulo, Fac Med, Sao Paulo, BrazilTyler J. Wellman - Invicro (United States)Soshi Hashimoto - Kyoto Okamoto Mem Hosp, Dept Anesthesiol, Kyoto, JapanCongli Zeng - Massachusetts General HospitalAlysson R. Carvalho - Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de JaneiroMarcos Francisco Vidal Melo - Massachusetts General Hospital
- Resource Type
- Journal article
- Publication Details
- Academic radiology, Vol.27(12), pp.1679-1690
- DOI
- 10.1016/j.acra.2019.12.022
- PMID
- 32173290
- NLM abbreviation
- Acad Radiol
- ISSN
- 1076-6332
- eISSN
- 1878-4046
- Publisher
- Elsevier
- Number of pages
- 12
- Language
- English
- Date published
- 12/01/2020
- Academic Unit
- Anesthesia
- Record Identifier
- 9985142950702771
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