Abstract

The use of dry gases during mechanical ventilation has been associated with the risk of serious airway complications. The goal of the present study was to quantify the plasma levels of TNF-alpha and IL-6 and to determine the radiological, hemodynamic, gasometric, and microscopic changes in lung mechanics in dogs subjected to short-term mechanical ventilation with and without humidification of the inhaled gas. The experiment was conducted for 24 hours in 10 dogs divided into two groups: Group I (n = 5), mechanical ventilation with dry oxygen dispensation, and Group II (n = 5), mechanical ventilation with oxygen dispensation using a moisture chamber. Variance analysis was used. No changes in physiological, hemodynamic, or gasometric, and radiographic constants were observed. Plasma TNF-alpha levels increased in group I, reaching a maximum 24 hours after mechanical ventilation was initiated (ANOVA p = 0.77). This increase was correlated to changes in mechanical ventilation. Plasma IL-6 levels decreased at 12 hours and increased again towards the end of the study (ANOVA p>0.05). Both groups exhibited a decrease in lung compliance and functional residual capacity values, but this was more pronounced in group I. Pplat increased in group I (ANOVA p = 0.02). Inhalation of dry gas caused histological lesions in the entire respiratory tract, including pulmonary parenchyma, to a greater extent than humidified gas. Humidification of inspired gases can attenuate damage associated with mechanical ventilation.

Highlights

  • Mechanical ventilation (MV) is used in patients with respiratory failure and during general anesthesia

  • Plasma levels of tumor necrosis factor alpha (TNF-a) and interleukin 6 (IL-6) Plasma TNF-a levels increased in group I, reaching a maximum

  • This increase was significantly correlated to changes in TNF-a /Cstat (r = 0.999* p = 0.026); TNF-a /Pplat (r = 0.998* p = 0.03) and TNF-a /Functional residual capacity (FRC) (r = 21** p = 0.009) (Figure 1 and Table 2)

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Summary

Introduction

Mechanical ventilation (MV) is used in patients with respiratory failure and during general anesthesia. Under natural ventilation conditions, inhaled air is conditioned during its passage through the airways When it reaches the alveoli, the air is fully saturated with water and is at body temperature (37uC, 100% relative humidity). Patients subjected to MV lose the natural warming and humidifying functions for inhaled gases in the upper airway, which increases the risk of serious airway complications, including alterations in mucociliary transport, thickening of secretions, clogging of the airway with mucus, and ciliary dyskinesia. These complications can lead to hypothermia, hypoxemia, atelectasis, and inflammation [1,2,3]. To maintain airway integrity, preserve mucociliary function, and improve gas exchange, inhaled gases should be humidified and warmed during MV with tracheal intubation [6,7,8]

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