Publication

Lung epithelial injury markers are not influenced by use of lower tidal volumes during elective surgery in patients without preexisting lung injury

Determann, R. M., Wolthuis, E. K., Choi, G., Bresser, P., Bernard, A., Lutter, R. & Schultz, M. J., 11-Feb-2008, In : American Journal of Physiology - Lung Cellular and Molecular Physiology. 294, 2, p. L344-L350

Research output: Contribution to journalArticleAcademicpeer-review

  • Rogier M. Determann
  • Esther K. Wolthuis
  • Goda Choi
  • Paul Bresser
  • Alfred Bernard
  • Rene Lutter
  • Marcus J. Schultz

Clara cell protein levels are elevated in plasma of individuals with mild or subclinical lung injury. We studied the influence of two mechanical ventilation strategies on local and systemic levels of Clara cell protein (CC16) and compared them with levels of soluble receptor for advanced glycation end products (sRAGE) and surfactant proteins (SP)-A and -D in patients undergoing elective surgery. Saved samples from a previously reported investigation were used for the study. Forty patients planned for elective surgery were randomized to mechanical ventilation with either a conventional tidal volume (V(T)) of 12 ml/kg without positive end-expiratory pressure (PEEP) or low V(T) of 6 ml/kg and 10 cmH(2)O PEEP. Plasma and bronchoalveolar lavage fluid (BALF) was collected directly after intubation and after 5 h of mechanical ventilation. While systemic levels of SP-A and SP-D remained unchanged, systemic levels of CC16 and sRAGE increased significantly in both groups after 5 h (P < 0.001 for both). BALF levels of SP-A, SP-D, CC16, and sRAGE remained unaffected. No differences were found between the two mechanical ventilation strategies regarding any of the measured biological markers. In conclusion, systemic levels of CC16 and sRAGE rise after 5 h in patients receiving mechanical ventilation for elective surgery. Mechanical ventilation with lower tidal volumes and PEEP did not have a different effect on levels of biomarkers of lung epithelial injury compared with conventional mechanical ventilation.

Original languageEnglish
Pages (from-to)L344-L350
JournalAmerican Journal of Physiology - Lung Cellular and Molecular Physiology
Volume294
Issue number2
Publication statusPublished - 11-Feb-2008
Externally publishedYes

    Keywords

  • Advanced Glycosylation End Product-Specific Receptor, Albumins, Alpha-Globulins, Biomarkers, Bronchoalveolar Lavage Fluid, Elective Surgical Procedures, Epithelium, Female, Humans, Lung Diseases, Male, Middle Aged, Perioperative Care, Pulmonary Surfactant-Associated Protein A, Pulmonary Surfactant-Associated Protein D, Receptors, Immunologic, Solubility, Tidal Volume, Uteroglobin

ID: 29061528