Alveolar preservation with high inflation pressure and intermediate oxygen concentration reduces ischemia-reperfusion injury of the lung

NP (Niels) van der Kaaij, J Kluin, R Lachmann, Michael den Bakker, Bart Lambrecht, BF (Burkhard) Lachmann, Ron de Bruin, Ad Bogers

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Abstract

BACKGROUND: This study investigated the optimal alveolar oxygen concentration and inflation pressure during ischemia that reduces lung ischemia reperfusion injury (URI). METHODS: Male Sprague-Dawley rats (n = 66) underwent 150 minutes of left lung ischemia by hilar clamping at an airway inflation pressure (P) of 5 or 30 cm H2O and an oxygen (O) concentration of 0%, 30%, or 100% (P5O0, P5O3, P5O100, P30O0, P30O30 and P30O100 groups). Lungs preserved with 0% oxygen were inflated with 100% nitrogen. Measurements of arterial blood gas values, pulmonary compliance, histology, flow cytometry of bronchoalveolar lavage fluid were performed on day 2 postoperatively. RESULTS: Inflation with 30 cm H2O resulted in increased partial pressure of arterial oxygen (Pao(2)) and lung compliance, decreased diffuse alveolar damage, and less infiltration of CD4(+) and CD8(+) lymphocytes and major histocompatibility complex class II-positive (MHCII+) antigen-presenting cells (APCs) in the left lung on day 2 compared with clamping at an airway inflation pressure of 5 cm H2O. The 100% oxygen groups demonstrated a lower Pao and a decreased pulmonary compliance than 30% oxyg CONCLUSION: Alveolar inflation with a pressure of 30 cm H2O and an oxygen concentration of 30% decreases the severity of LIRI. The protective effect is mainly due to hyperinflation and, to a lesser extent, through oxygen concentration. J Heart Lung Transplant 2012;31:531-7 (C) 2012 International Society for Heart and Lung Transplantation. All rights reserved.
Original languageUndefined/Unknown
Pages (from-to)531-537
Number of pages7
JournalJournal of Heart and Lung Transplantation
Volume31
Issue number5
DOIs
Publication statusPublished - 2012

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