Abstract

BackgroundLong-term mechanical ventilation with hyperoxia can induce lung injury. General anesthesia is associated with a very high incidence of hyperoxaemia, despite it usually lasts for a relatively short period of time. It remains unclear whether short-term mechanical ventilation with hyperoxia has an adverse impact on or cause injury to the lungs. The present study aimed to assess whether short-term mechanical ventilation with hyperoxia may cause lung injury in rats and whether deferoxamine (DFO), a ferrous ion chelator, could mitigate such injury to the lungs and explore the possible mechanism.MethodsTwenty-four SD rats were randomly divided into 3 groups (n = 8/group): mechanical ventilated with normoxia group (MV group, FiO2 = 21%), with hyperoxia group (HMV group, FiO2 = 90%), or with hyperoxia + DFO group (HMV + DFO group, FiO2 = 90%). Mechanical ventilation under different oxygen concentrations was given for 4 h, and ECG was monitored. The HMV + DFO group received continuous intravenous infusion of DFO at 50 mg•kg− 1•h− 1, while the MV and HMV groups received an equal volume of normal saline. Carotid artery cannulation was carried out to monitor the blood gas parameters under mechanical ventilation for 2 and 4 h, respectively, and the PaO2/FiO2 ratio was calculated. After 4 h ventilation, the right anterior lobe of the lung and bronchoalveolar lavage fluid from the right lung was sampled for pathological and biochemical assays.ResultsPaO2 in the HMV and HMV + DFO groups were significantly higher, but the PaO2/FiO2 ratio were significantly lower than those of the MV group (all p < 0.01), while PaO2 and PaO2/FiO2 ratio between HMV + DFO and HMV groups did not differ significantly. The lung pathological scores and the wet-to-dry weight ratio (W/D) in the HMV and HMV + DFO groups were significantly higher than those of the MV group, but the lung pathological score and the W/D ratio were reduced by DFO (p < 0.05, HMV + DFO vs. HMV). Biochemically, HMV resulted in significant reductions in Surfactant protein C (SP-C), Surfactant protein D (SP-D), and Glutathion reductase (GR) levels and elevation of xanthine oxidase (XOD) in both the Bronchoalveolar lavage fluid and the lung tissue homogenate, and all these changes were prevented or significantly reverted by DFO.ConclusionsMechanical ventilation with hyperoxia for 4 h induced oxidative injury of the lungs, accompanied by a dramatic reduction in the concentrations of SP-C and SP-D. DFO could mitigate such injury by lowering XOD activity and elevating GR activity.

Highlights

  • Long-term mechanical ventilation with hyperoxia can induce lung injury

  • Data of blood gases At 2 and 4 h of mechanical ventilation, blood gas analysis showed that as compared with the MV group, PaO2 increased in the HMV and HMV + DFO groups (P< 0.001), while PaO2/Fraction of inspired oxygen (FiO2) ratio decreased (P

  • There were no significant differences in PaO2 and PaO2/ FiO2 ratio between the HMV and HMV + DFO groups (P>0.05)

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Summary

Introduction

General anesthesia is associated with a very high incidence of hyperoxaemia, despite it usually lasts for a relatively short period of time It remains unclear whether short-term mechanical ventilation with hyperoxia has an adverse impact on or cause injury to the lungs. As shown in the animal experiments, long-term exposure to the hyperoxic environment caused oxidative injury of the lungs [9], and another clinical study indicated that long-term hyperoxia increased the risks of lung complications in humans, including pneumonia, atelectasis and pulmonary edema [10] It remains unclear whether or not shortterm hyperoxia exerts an adverse impact on the lung tissues. Since most of the surgeries under general anesthesia are accomplished over relatively a short time, this study was concerned whether mechanical ventilation with hyperoxia for 4 h would cause oxidative injury of the lungs

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