Pressure-support compared with pressure-controlled ventilation mitigates lung and brain injury in experimental acute ischemic stroke in rats

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorSILVA, Adriana L. da
dc.contributor.authorBESSA, Camila M.
dc.contributor.authorROCHA, Nazareth N.
dc.contributor.authorCARVALHO, Eduardo B.
dc.contributor.authorMAGALHAES, Raquel F.
dc.contributor.authorCAPELOZZI, Vera L.
dc.contributor.authorROBBA, Chiara
dc.contributor.authorPELOSI, Paolo
dc.contributor.authorSAMARY, Cynthia S.
dc.contributor.authorROCCO, Patricia R. M.
dc.contributor.authorSILVA, Pedro L.
dc.date.accessioned2024-02-15T14:53:17Z
dc.date.available2024-02-15T14:53:17Z
dc.date.issued2023
dc.description.abstractBackground We aimed to evaluate the pulmonary and cerebral effects of low-tidal volume ventilation in pressure-support (PSV) and pressure-controlled (PCV) modes at two PEEP levels in acute ischemic stroke (AIS).Methods In this randomized experimental study, AIS was induced by thermocoagulation in 30 healthy male Wistar rats. After 24 h, AIS animals were randomly assigned to PSV or PCV with V-T = 6 mL/kg and PEEP = 2 cmH(2)O (PSV-PEEP2 and PCV-PEEP2) or PEEP = 5 cmH(2)O (PSV-PEEP5 and PCV-PEEP5) for 2 h. Lung mechanics, arterial blood gases, and echocardiography were evaluated before and after the experiment. Lungs and brain tissue were removed for histologic and molecular biology analysis. The primary endpoint was diffuse alveolar damage (DAD) score; secondary endpoints included brain histology and brain and lung molecular biology markers.Results In lungs, DAD was lower with PSV-PEEP5 than PCV-PEEP5 (p < 0.001); interleukin (IL)-1 beta was lower with PSV-PEEP2 than PCV-PEEP2 (p = 0.016) and PSV-PEEP5 than PCV-PEEP5 (p = 0.046); zonula occludens-1 (ZO-1) was lower in PCV-PEEP5 than PCV-PEEP2 (p = 0.042). In brain, necrosis, hemorrhage, neuropil edema, and CD45 + microglia were lower in PSV than PCV animals at PEEP = 2 cmH(2)O (p = 0.036, p = 0.025, p = 0.018, p = 0.011, respectively) and PEEP = 5 cmH(2)O (p = 0.003, p = 0.003, p = 0.007, p = 0.003, respectively); IL-1 beta was lower while ZO-1 was higher in PSV-PEEP2 than PCV-PEEP2 (p = 0.009, p = 0.007, respectively), suggesting blood-brain barrier integrity. Claudin-5 was higher in PSV-PEEP2 than PSV-PEEP5 (p = 0.036).Conclusion In experimental AIS, PSV compared with PCV reduced lung and brain injury. Lung ZO-1 reduced in PCV with PEEP = 2 versus PEEP = 5 cmH(2)O, while brain claudin-5 increased in PSV with PEEP = 2 versus PEEP = 5 cmH(2)O.eng
dc.description.indexPubMed
dc.description.indexWoS
dc.description.indexScopus
dc.description.sponsorshipBrazilian Council for Scientific and Technological Development (CNPq) [2019/12151-0]
dc.description.sponsorshipRio de Janeiro State Research Foundation (FAPERJ) [E-26/202.766/2018, E-26/010.001488/2019]
dc.description.sponsorshipSao Paulo State Research Foundation (FAPESP) [88881.371450/2019-01]
dc.description.sponsorshipCoordination for the Improvement of Higher Education Personnel (CAPES)
dc.description.sponsorshipDepartment of Science and Technology-Brazilian Ministry of Health (DECIT/MS)
dc.description.sponsorship[2018/20493-6]
dc.identifier.citationINTENSIVE CARE MEDICINE EXPERIMENTAL, v.11, n.1, article ID 93, 12p, 2023
dc.identifier.doi10.1186/s40635-023-00580-w
dc.identifier.issn2197-425X
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/58041
dc.language.isoeng
dc.publisherSPRINGEReng
dc.relation.ispartofIntensive Care Medicine Experimental
dc.rightsopenAccesseng
dc.rights.holderCopyright SPRINGEReng
dc.subjectAcute ischemic strokeeng
dc.subjectMechanical ventilationeng
dc.subjectLung injuryeng
dc.subjectBrain injuryeng
dc.subject.othermechanical ventilationeng
dc.subject.otherfluideng
dc.subject.otherrecommendationseng
dc.subject.othersocietyeng
dc.subject.othertimeeng
dc.subject.otherfloweng
dc.subject.wosCritical Care Medicineeng
dc.titlePressure-support compared with pressure-controlled ventilation mitigates lung and brain injury in experimental acute ischemic stroke in ratseng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.affiliation.countryItália
hcfmusp.affiliation.countryisoit
hcfmusp.author.externalSILVA, Adriana L. da:Univ Fed Rio de Janeiro, Carlos Chagas Filho Inst Biophys, Ctr Ciencias Saude, Lab Pulm Invest, Ave Carlos Chagas Filho,S-N,Bloco G-014, BR-21941902 Rio De Janeiro, RJ, Brazil
hcfmusp.author.externalBESSA, Camila M.:Univ Fed Rio de Janeiro, Carlos Chagas Filho Inst Biophys, Ctr Ciencias Saude, Lab Pulm Invest, Ave Carlos Chagas Filho,S-N,Bloco G-014, BR-21941902 Rio De Janeiro, RJ, Brazil
hcfmusp.author.externalROCHA, Nazareth N.:Univ Fed Rio de Janeiro, Carlos Chagas Filho Inst Biophys, Ctr Ciencias Saude, Lab Pulm Invest, Ave Carlos Chagas Filho,S-N,Bloco G-014, BR-21941902 Rio De Janeiro, RJ, Brazil; Fluminense Fed Univ, Biomed Inst, Dept Physiol & Pharmacol, Rio De Janeiro, Brazil
hcfmusp.author.externalCARVALHO, Eduardo B.:Univ Fed Rio de Janeiro, Carlos Chagas Filho Inst Biophys, Ctr Ciencias Saude, Lab Pulm Invest, Ave Carlos Chagas Filho,S-N,Bloco G-014, BR-21941902 Rio De Janeiro, RJ, Brazil
hcfmusp.author.externalMAGALHAES, Raquel F.:Univ Fed Rio de Janeiro, Carlos Chagas Filho Inst Biophys, Ctr Ciencias Saude, Lab Pulm Invest, Ave Carlos Chagas Filho,S-N,Bloco G-014, BR-21941902 Rio De Janeiro, RJ, Brazil
hcfmusp.author.externalROBBA, Chiara:Univ Genoa, Dept Surg Sci & Integrated Diagnost DISC, Genoa, Italy; San Martino Policlin Hosp, Anesthesia & Crit Care, IRCCS Oncol & Neurosci, Genoa, Italy
hcfmusp.author.externalPELOSI, Paolo:Univ Genoa, Dept Surg Sci & Integrated Diagnost DISC, Genoa, Italy; San Martino Policlin Hosp, Anesthesia & Crit Care, IRCCS Oncol & Neurosci, Genoa, Italy
hcfmusp.author.externalSAMARY, Cynthia S.:Univ Fed Rio de Janeiro, Carlos Chagas Filho Inst Biophys, Ctr Ciencias Saude, Lab Pulm Invest, Ave Carlos Chagas Filho,S-N,Bloco G-014, BR-21941902 Rio De Janeiro, RJ, Brazil; Univ Fed Rio de Janeiro, Fac Physiotherapy, Dept Cardioresp & Musculoskeletal Physiotherapy, Rio De Janeiro, Brazil
hcfmusp.author.externalROCCO, Patricia R. M.:Univ Fed Rio de Janeiro, Carlos Chagas Filho Inst Biophys, Ctr Ciencias Saude, Lab Pulm Invest, Ave Carlos Chagas Filho,S-N,Bloco G-014, BR-21941902 Rio De Janeiro, RJ, Brazil
hcfmusp.author.externalSILVA, Pedro L.:Univ Fed Rio de Janeiro, Carlos Chagas Filho Inst Biophys, Ctr Ciencias Saude, Lab Pulm Invest, Ave Carlos Chagas Filho,S-N,Bloco G-014, BR-21941902 Rio De Janeiro, RJ, Brazil
hcfmusp.citation.scopus0
hcfmusp.contributor.author-fmusphcVERA LUIZA CAPELOZZI
hcfmusp.description.articlenumber93
hcfmusp.description.issue1
hcfmusp.description.volume11
hcfmusp.origemWOS
hcfmusp.origem.pubmed38102452
hcfmusp.origem.scopus2-s2.0-85179748216
hcfmusp.origem.wosWOS:001126165800001
hcfmusp.publisher.cityNEW YORKeng
hcfmusp.publisher.countryUNITED STATESeng
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