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dc.contributor.authorOliveira, Roselaine Pinheiro dept_BR
dc.contributor.authorHetzel, Marcio Pereirapt_BR
dc.contributor.authorSilva, Mauro dos Anjospt_BR
dc.contributor.authorDallegrave, Danielapt_BR
dc.contributor.authorFriedman, Gilbertopt_BR
dc.date.accessioned2010-07-01T04:18:38Zpt_BR
dc.date.issued2010pt_BR
dc.identifier.issn1364-8535pt_BR
dc.identifier.urihttp://hdl.handle.net/10183/24192pt_BR
dc.description.abstractIntroduction: Mechanical ventilation (MV) with high tidal volumes may induce or aggravate lung injury in critical ill patients. We compared the effects of a protective versus a conventional ventilatory strategy, on systemic and lung production of tumor necrosis factor-a (TNF-a) and interleukin-8 (IL-8) in patients without lung disease. Methods: Patients without lung disease and submitted to mechanical ventilation admitted to one trauma and one general adult intensive care unit of two different university hospitals were enrolled in a prospective randomizedcontrol study. Patients were randomized to receive MV either with tidal volume (VT) of 10 to 12 ml/kg predicted body weight (high VT group) (n = 10) or with VT of 5 to 7 ml/kg predicted body weight (low VT group) (n = 10) with an oxygen inspiratory fraction (FIO2) enough to keep arterial oxygen saturation >90% with positive endexpiratory pressure (PEEP) of 5 cmH2O during 12 hours after admission to the study. TNF-a and IL-8 concentrations were measured in the serum and in the bronchoalveolar lavage fluid (BALF) at admission and after 12 hours of study observation time. Results: Twenty patients were enrolled and analyzed. At admission or after 12 hours there were no differences in serum TNF-a and IL-8 between the two groups. While initial analysis did not reveal significant differences, standardization against urea of logarithmic transformed data revealed that TNF-a and IL-8 levels in bronchoalveolar lavage (BAL) fluid were stable in the low VT group but increased in the high VT group (P = 0.04 and P = 0.03). After 12 hours, BALF TNF-a (P = 0.03) and BALF IL-8 concentrations (P = 0.03) were higher in the high VT group than in the low VT group. Conclusions: The use of lower tidal volumes may limit pulmonary inflammation in mechanically ventilated patients even without lung injury. Trial Registration: Clinical Trial registration: NCT00935896.en
dc.format.mimetypeapplication/pdf
dc.language.isoengpt_BR
dc.relation.ispartofCritical Care. London. Vol. 14, (Mar. 2010), 9 p.pt_BR
dc.rightsOpen Accessen
dc.subjectRespiração artificialpt_BR
dc.subjectPneumopatiaspt_BR
dc.subjectInflamaçãopt_BR
dc.titleMechanical ventilation with high tidal volume induces inflammation in patients without lung diseasept_BR
dc.typeArtigo de periódicopt_BR
dc.identifier.nrb000746109pt_BR
dc.type.originEstrangeiropt_BR


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