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Sci Rep. 2018 Apr 24;8(1):6439. doi: 10.1038/s41598-018-24615-5.

Pulmonary Effects of Adjusting Tidal Volume to Actual or Ideal Body Weight in Ventilated Obese Mice.

Author information

1
INSERM U955, Université Paris Est (UPEC), Faculté de Médecine, 94000, Créteil, France. eguivarch@hpsj.fr.
2
AP-HP, HU Hôpital Bichat-Claude Bernard, Département d'anesthésie-réanimation, 75018, Paris, France. eguivarch@hpsj.fr.
3
Hôpital Paris Saint Joseph, Service d'anesthésie, 75014, Paris, France. eguivarch@hpsj.fr.
4
INSERM U955, Université Paris Est (UPEC), Faculté de Médecine, 94000, Créteil, France.
5
AP-HP, HU Hôpital Tenon, Service de réanimation, 75020, Paris, France.
6
Université Paris Est Créteil (UPEC), Faculté de Médecine de Créteil, IMRB, GRC CARMAS, Créteil, 94000, France.
7
CHU Lille, Centre de Réanimation, Lille, 59000, France.
8
UPEC and AP-HP, HU Henri Mondor, Département de pathologie, 94000, Créteil, France.
9
AP-HP, HU Hôpital Bichat-Claude Bernard, Département d'anesthésie-réanimation, 75018, Paris, France.
10
INSERM UMR 1152, Faculté de médecine Paris Diderot Paris 7, 94000, Paris, France.
11
AP-HP, HU Hôpital Henri Mondor, DHU A-TVB, Antenne de Pneumologie, 94000, Créteil, France.
12
AP-HP, HU Hôpital Henri Mondor, DHU A-TVB, Service de réanimation médicale, 94000, Créteil, France.
13
Centre hospitalier sud francilien, Service de réanimation, 91100, Corbeil-Essonnes, France.

Abstract

Obese patients could be more susceptible to mechanical ventilation (MV)-induced lung injury than non-obese patients due to weight-dependent changes in lung properties. The aim of this study was therefore to evaluate the pulmonary effects of 2 hours low VT MV in a diet-induced obese mice model, with VT calculated on either the actual body weight (VTaw) or the ideal body weight (VTiw) . First, we hypothesized that a MV with VTaw would be associated with altered lung mechanics and an increased lung inflammation. Second, we hypothesised that a MV with a VTiw would preserve lung mechanics and limit lung inflammation. We analyzed lung mechanics and inflammation using bronchoalveolar lavage (BAL) cell counts, flow cytometry tissue analysis and histology. Lung mechanics and inflammation were comparable in control and obese mice receiving VTiw. By contrast, obese mice receiving VTaw had significantly more alterations in lung mechanics, BAL cellularity and lung influx of monocytes as compared to control mice. Their monocyte expression of Gr1 and CD62L was also increased. Alveolar neutrophil infiltration was significantly increased in all obese mice as compared to controls. In conclusion, our findings suggest that protective MV with a VTaw is deleterious, with a marked alteration in lung mechanics and associated lung inflammation as compared to lean mice. With VTiw, lung mechanics and inflammation were close to that of control mice, except for an increased alveolar infiltrate of polymorphonuclear neutrophils. This inflammation might be attenuated by a blunted recruitment of inflammatory cells associated with obesity.

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