Effects of prone position ventilation on inflammatory factors in blood and bronchial alveolar lavage fluid of acute respiratory distress syndrome dogs caused by pulmonary and extrapulmonary insults

Abstract

To observe the changes of inflammatory factors in blood and bronchial alveolar lavage fluid (BALF) of different lung areas of acute respiratory distress syndrome (ARDS) dogs caused by pulmonary and extra-pulmonary causes with low tidal volume and positive end expiratory pressure (PEEP) treatment under prone position ventilation. 24 male mongrel dogs were randomly divided into 4 equal groups:ARDSp (ARDS caused by pulmonary causes) experimental group, ARDSp control group, ARDSexp (ARDS caused by extra-pulmonary causes) experimental group, and ARDSexp control group. The ARDSp dogs inspired detergent to cause lung injury, and the ARDSexp dogs were injected with oleic acid through central vein. The results of TNF-alpha, IL-1beta, and IL-6 of blood and BALF in different areas of dog's lung (upper lobe, heart lobe, and diaphragm lobe) and arterial blood gas under lung protective ventilation treatment were measured. After lung injury, the arterial oxygenation index as decreased, and the values of TNF-alpha, IL-1beta, and IL-6 in plasma were obviously getting higher in all groups. The values of inflammatory factors in the BALF from upper lobe and heart lobe of ARDSp dogs were significantly higher than those of the ARDSexp dogs. After receiving low tidal volume and PEEP ventilation under prone position, all dogs were gradually getting ameliorated. There are statistically those of the differences in inflammatory factor releasing in different lung areas between the ARDSp dogs and ARDSexp dogs, and low tidal volume and PEEP treatment under prone position ventilation shows good effects both on ARDSexp dogs and ARDSp dogs.