Effects of surfactant depletion on regional pulmonary metabolic activity during mechanical ventilation
Inflammation during mechanical ventilation is thought to depend on regional mechanical stress. This can be produced by concentration of stresses and cyclic recruitment in low-aeration dependent lung. Positron emission tomography (PET) with (18)F-fluorodeoxyglucose ((18)F-FDG) allows for noninvasive...
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| creator | DE PROST, Nicolas COSTA, Eduardo L WELLMAN, Tyler MUSCH, Guido WINKLER, Tilo TUCCI, Mauro R HARRIS, R. Scott VENEGAS, Jose G VIDAL MELO, Marcos F |
| description | Inflammation during mechanical ventilation is thought to depend on regional mechanical stress. This can be produced by concentration of stresses and cyclic recruitment in low-aeration dependent lung. Positron emission tomography (PET) with (18)F-fluorodeoxyglucose ((18)F-FDG) allows for noninvasive assessment of regional metabolic activity, an index of neutrophilic inflammation. We tested the hypothesis that, during mechanical ventilation, surfactant-depleted low-aeration lung regions present increased regional (18)F-FDG uptake suggestive of in vivo increased regional metabolic activity and inflammation. Sheep underwent unilateral saline lung lavage and were ventilated supine for 4 h (positive end-expiratory pressure = 10 cmH(2)O, tidal volume adjusted to plateau pressure = 30 cmH(2)O). We used PET scans of injected (13)N-nitrogen to compute regional perfusion and ventilation and injected (18)F-FDG to calculate (18)F-FDG uptake rate. Regional aeration was quantified with transmission scans. Whole lung (18)F-FDG uptake was approximately two times higher in lavaged than in nonlavaged lungs (2.9 ± 0.6 vs. 1.5 ± 0.3 10(-3)/min; P < 0.05). The increased (18)F-FDG uptake was topographically heterogeneous and highest in dependent low-aeration regions (gas fraction 10-50%, P < 0.001), even after correction for lung density and wet-to-dry lung ratios. (18)F-FDG uptake in low-aeration regions of lavaged lungs was higher than that in low-aeration regions of nonlavaged lungs (P < 0.05). This occurred despite lower perfusion and ventilation to dependent regions in lavaged than nonlavaged lungs (P < 0.001). In contrast, (18)F-FDG uptake in normally aerated regions was low and similar between lungs. Surfactant depletion produces increased and heterogeneously distributed pulmonary (18)F-FDG uptake after 4 h of supine mechanical ventilation. Metabolic activity is highest in poorly aerated dependent regions, suggesting local increased inflammation. |
| doi_str_mv | 10.1152/japplphysiol.00311.2011 |
| format | Article |
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Scott ; VENEGAS, Jose G ; VIDAL MELO, Marcos F</creator><creatorcontrib>DE PROST, Nicolas ; COSTA, Eduardo L ; WELLMAN, Tyler ; MUSCH, Guido ; WINKLER, Tilo ; TUCCI, Mauro R ; HARRIS, R. Scott ; VENEGAS, Jose G ; VIDAL MELO, Marcos F</creatorcontrib><description>Inflammation during mechanical ventilation is thought to depend on regional mechanical stress. This can be produced by concentration of stresses and cyclic recruitment in low-aeration dependent lung. Positron emission tomography (PET) with (18)F-fluorodeoxyglucose ((18)F-FDG) allows for noninvasive assessment of regional metabolic activity, an index of neutrophilic inflammation. We tested the hypothesis that, during mechanical ventilation, surfactant-depleted low-aeration lung regions present increased regional (18)F-FDG uptake suggestive of in vivo increased regional metabolic activity and inflammation. Sheep underwent unilateral saline lung lavage and were ventilated supine for 4 h (positive end-expiratory pressure = 10 cmH(2)O, tidal volume adjusted to plateau pressure = 30 cmH(2)O). We used PET scans of injected (13)N-nitrogen to compute regional perfusion and ventilation and injected (18)F-FDG to calculate (18)F-FDG uptake rate. Regional aeration was quantified with transmission scans. Whole lung (18)F-FDG uptake was approximately two times higher in lavaged than in nonlavaged lungs (2.9 ± 0.6 vs. 1.5 ± 0.3 10(-3)/min; P < 0.05). The increased (18)F-FDG uptake was topographically heterogeneous and highest in dependent low-aeration regions (gas fraction 10-50%, P < 0.001), even after correction for lung density and wet-to-dry lung ratios. (18)F-FDG uptake in low-aeration regions of lavaged lungs was higher than that in low-aeration regions of nonlavaged lungs (P < 0.05). This occurred despite lower perfusion and ventilation to dependent regions in lavaged than nonlavaged lungs (P < 0.001). In contrast, (18)F-FDG uptake in normally aerated regions was low and similar between lungs. Surfactant depletion produces increased and heterogeneously distributed pulmonary (18)F-FDG uptake after 4 h of supine mechanical ventilation. Metabolic activity is highest in poorly aerated dependent regions, suggesting local increased inflammation.</description><identifier>ISSN: 8750-7587</identifier><identifier>EISSN: 1522-1601</identifier><identifier>DOI: 10.1152/japplphysiol.00311.2011</identifier><identifier>PMID: 21799132</identifier><identifier>CODEN: JAPHEV</identifier><language>eng</language><publisher>Bethesda, MD: American Physiological Society</publisher><subject>Animals ; Biological and medical sciences ; Bronchoalveolar Lavage - methods ; Fluorodeoxyglucose F18 - pharmacokinetics ; Fundamental and applied biological sciences. Psychology ; Glucose ; Inflammation - diagnostic imaging ; Inflammation - drug therapy ; Inflammation - metabolism ; Lung - diagnostic imaging ; Lung - metabolism ; Lungs ; Metabolism ; Nitrogen Radioisotopes - administration & dosage ; Positive-Pressure Respiration - methods ; Positron-Emission Tomography - methods ; Pulmonary Surfactants - metabolism ; Radiopharmaceuticals - pharmacokinetics ; Respiration, Artificial - methods ; Sheep ; Stress, Mechanical ; Tomography ; Ventilation</subject><ispartof>Journal of applied physiology (1985), 2011-11, Vol.111 (5), p.1249-1258</ispartof><rights>2015 INIST-CNRS</rights><rights>Copyright American Physiological Society Nov 2011</rights><rights>Copyright © 2011 the American Physiological Society 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c473t-dfcb9ec984a31dd132f686a15c22fee2c0bf20bf7e8a3ac014ae8fbdb80640743</citedby><cites>FETCH-LOGICAL-c473t-dfcb9ec984a31dd132f686a15c22fee2c0bf20bf7e8a3ac014ae8fbdb80640743</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,3039,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24735609$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21799132$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>DE PROST, Nicolas</creatorcontrib><creatorcontrib>COSTA, Eduardo L</creatorcontrib><creatorcontrib>WELLMAN, Tyler</creatorcontrib><creatorcontrib>MUSCH, Guido</creatorcontrib><creatorcontrib>WINKLER, Tilo</creatorcontrib><creatorcontrib>TUCCI, Mauro R</creatorcontrib><creatorcontrib>HARRIS, R. Scott</creatorcontrib><creatorcontrib>VENEGAS, Jose G</creatorcontrib><creatorcontrib>VIDAL MELO, Marcos F</creatorcontrib><title>Effects of surfactant depletion on regional pulmonary metabolic activity during mechanical ventilation</title><title>Journal of applied physiology (1985)</title><addtitle>J Appl Physiol (1985)</addtitle><description>Inflammation during mechanical ventilation is thought to depend on regional mechanical stress. This can be produced by concentration of stresses and cyclic recruitment in low-aeration dependent lung. Positron emission tomography (PET) with (18)F-fluorodeoxyglucose ((18)F-FDG) allows for noninvasive assessment of regional metabolic activity, an index of neutrophilic inflammation. We tested the hypothesis that, during mechanical ventilation, surfactant-depleted low-aeration lung regions present increased regional (18)F-FDG uptake suggestive of in vivo increased regional metabolic activity and inflammation. Sheep underwent unilateral saline lung lavage and were ventilated supine for 4 h (positive end-expiratory pressure = 10 cmH(2)O, tidal volume adjusted to plateau pressure = 30 cmH(2)O). We used PET scans of injected (13)N-nitrogen to compute regional perfusion and ventilation and injected (18)F-FDG to calculate (18)F-FDG uptake rate. Regional aeration was quantified with transmission scans. Whole lung (18)F-FDG uptake was approximately two times higher in lavaged than in nonlavaged lungs (2.9 ± 0.6 vs. 1.5 ± 0.3 10(-3)/min; P < 0.05). The increased (18)F-FDG uptake was topographically heterogeneous and highest in dependent low-aeration regions (gas fraction 10-50%, P < 0.001), even after correction for lung density and wet-to-dry lung ratios. (18)F-FDG uptake in low-aeration regions of lavaged lungs was higher than that in low-aeration regions of nonlavaged lungs (P < 0.05). This occurred despite lower perfusion and ventilation to dependent regions in lavaged than nonlavaged lungs (P < 0.001). In contrast, (18)F-FDG uptake in normally aerated regions was low and similar between lungs. Surfactant depletion produces increased and heterogeneously distributed pulmonary (18)F-FDG uptake after 4 h of supine mechanical ventilation. Metabolic activity is highest in poorly aerated dependent regions, suggesting local increased inflammation.</description><subject>Animals</subject><subject>Biological and medical sciences</subject><subject>Bronchoalveolar Lavage - methods</subject><subject>Fluorodeoxyglucose F18 - pharmacokinetics</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Glucose</subject><subject>Inflammation - diagnostic imaging</subject><subject>Inflammation - drug therapy</subject><subject>Inflammation - metabolism</subject><subject>Lung - diagnostic imaging</subject><subject>Lung - metabolism</subject><subject>Lungs</subject><subject>Metabolism</subject><subject>Nitrogen Radioisotopes - administration & dosage</subject><subject>Positive-Pressure Respiration - methods</subject><subject>Positron-Emission Tomography - methods</subject><subject>Pulmonary Surfactants - metabolism</subject><subject>Radiopharmaceuticals - pharmacokinetics</subject><subject>Respiration, Artificial - methods</subject><subject>Sheep</subject><subject>Stress, Mechanical</subject><subject>Tomography</subject><subject>Ventilation</subject><issn>8750-7587</issn><issn>1522-1601</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVUV1rGzEQFKWlcdP-hfYo9PEcrXSfL4US0g8I5CV5Fns6yZaRT1dJZ_C_z7px0xQktDCzo9kdxj4BXwPU4mqH8-zn7TG54NecS4C14ACv2IpQUULD4TVbdW3Ny7bu2gv2LqUd51BVNbxlFwLavgcpVszeWGt0TkWwRVqiRZ1xysVoZm-yC1NBJ5oNVeiLefF7KuKx2JuMQ_BOF9TgDi4fi3GJbtoQorc4OU30g5my83iSec_eWPTJfDi_l-zh-8399c_y9u7Hr-tvt6WuWpnL0eqhN7rvKpQwjuTQNl2DUGshrDFC88EKuq3pUKKmedB0dhiHjjcVbyt5yb4-6c7LsDejJgcRvZqj25NtFdCp_5HJbdUmHJQUgkvek8Dns0AMvxeTstqFJdLwSfW87voauCRS-0TSMaQUjX3-ALg65aNe5qP-5KNO-VDnx5f-nvv-BkKEL2cCJtqhjThpl_7xaE11Qz4fAWP_oZE</recordid><startdate>20111101</startdate><enddate>20111101</enddate><creator>DE PROST, Nicolas</creator><creator>COSTA, Eduardo L</creator><creator>WELLMAN, Tyler</creator><creator>MUSCH, Guido</creator><creator>WINKLER, Tilo</creator><creator>TUCCI, Mauro R</creator><creator>HARRIS, R. Scott</creator><creator>VENEGAS, Jose G</creator><creator>VIDAL MELO, Marcos F</creator><general>American Physiological Society</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7QR</scope><scope>7TK</scope><scope>7TS</scope><scope>7U7</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>P64</scope><scope>5PM</scope></search><sort><creationdate>20111101</creationdate><title>Effects of surfactant depletion on regional pulmonary metabolic activity during mechanical ventilation</title><author>DE PROST, Nicolas ; COSTA, Eduardo L ; WELLMAN, Tyler ; MUSCH, Guido ; WINKLER, Tilo ; TUCCI, Mauro R ; HARRIS, R. Scott ; VENEGAS, Jose G ; VIDAL MELO, Marcos F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c473t-dfcb9ec984a31dd132f686a15c22fee2c0bf20bf7e8a3ac014ae8fbdb80640743</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Animals</topic><topic>Biological and medical sciences</topic><topic>Bronchoalveolar Lavage - methods</topic><topic>Fluorodeoxyglucose F18 - pharmacokinetics</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Glucose</topic><topic>Inflammation - diagnostic imaging</topic><topic>Inflammation - drug therapy</topic><topic>Inflammation - metabolism</topic><topic>Lung - diagnostic imaging</topic><topic>Lung - metabolism</topic><topic>Lungs</topic><topic>Metabolism</topic><topic>Nitrogen Radioisotopes - administration & dosage</topic><topic>Positive-Pressure Respiration - methods</topic><topic>Positron-Emission Tomography - methods</topic><topic>Pulmonary Surfactants - metabolism</topic><topic>Radiopharmaceuticals - pharmacokinetics</topic><topic>Respiration, Artificial - methods</topic><topic>Sheep</topic><topic>Stress, Mechanical</topic><topic>Tomography</topic><topic>Ventilation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DE PROST, Nicolas</creatorcontrib><creatorcontrib>COSTA, Eduardo L</creatorcontrib><creatorcontrib>WELLMAN, Tyler</creatorcontrib><creatorcontrib>MUSCH, Guido</creatorcontrib><creatorcontrib>WINKLER, Tilo</creatorcontrib><creatorcontrib>TUCCI, Mauro R</creatorcontrib><creatorcontrib>HARRIS, R. Scott</creatorcontrib><creatorcontrib>VENEGAS, Jose G</creatorcontrib><creatorcontrib>VIDAL MELO, Marcos F</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Chemoreception Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Toxicology Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of applied physiology (1985)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>DE PROST, Nicolas</au><au>COSTA, Eduardo L</au><au>WELLMAN, Tyler</au><au>MUSCH, Guido</au><au>WINKLER, Tilo</au><au>TUCCI, Mauro R</au><au>HARRIS, R. Scott</au><au>VENEGAS, Jose G</au><au>VIDAL MELO, Marcos F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of surfactant depletion on regional pulmonary metabolic activity during mechanical ventilation</atitle><jtitle>Journal of applied physiology (1985)</jtitle><addtitle>J Appl Physiol (1985)</addtitle><date>2011-11-01</date><risdate>2011</risdate><volume>111</volume><issue>5</issue><spage>1249</spage><epage>1258</epage><pages>1249-1258</pages><issn>8750-7587</issn><eissn>1522-1601</eissn><coden>JAPHEV</coden><abstract>Inflammation during mechanical ventilation is thought to depend on regional mechanical stress. This can be produced by concentration of stresses and cyclic recruitment in low-aeration dependent lung. Positron emission tomography (PET) with (18)F-fluorodeoxyglucose ((18)F-FDG) allows for noninvasive assessment of regional metabolic activity, an index of neutrophilic inflammation. We tested the hypothesis that, during mechanical ventilation, surfactant-depleted low-aeration lung regions present increased regional (18)F-FDG uptake suggestive of in vivo increased regional metabolic activity and inflammation. Sheep underwent unilateral saline lung lavage and were ventilated supine for 4 h (positive end-expiratory pressure = 10 cmH(2)O, tidal volume adjusted to plateau pressure = 30 cmH(2)O). We used PET scans of injected (13)N-nitrogen to compute regional perfusion and ventilation and injected (18)F-FDG to calculate (18)F-FDG uptake rate. Regional aeration was quantified with transmission scans. Whole lung (18)F-FDG uptake was approximately two times higher in lavaged than in nonlavaged lungs (2.9 ± 0.6 vs. 1.5 ± 0.3 10(-3)/min; P < 0.05). The increased (18)F-FDG uptake was topographically heterogeneous and highest in dependent low-aeration regions (gas fraction 10-50%, P < 0.001), even after correction for lung density and wet-to-dry lung ratios. (18)F-FDG uptake in low-aeration regions of lavaged lungs was higher than that in low-aeration regions of nonlavaged lungs (P < 0.05). This occurred despite lower perfusion and ventilation to dependent regions in lavaged than nonlavaged lungs (P < 0.001). In contrast, (18)F-FDG uptake in normally aerated regions was low and similar between lungs. Surfactant depletion produces increased and heterogeneously distributed pulmonary (18)F-FDG uptake after 4 h of supine mechanical ventilation. Metabolic activity is highest in poorly aerated dependent regions, suggesting local increased inflammation.</abstract><cop>Bethesda, MD</cop><pub>American Physiological Society</pub><pmid>21799132</pmid><doi>10.1152/japplphysiol.00311.2011</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Animals Biological and medical sciences Bronchoalveolar Lavage - methods Fluorodeoxyglucose F18 - pharmacokinetics Fundamental and applied biological sciences. Psychology Glucose Inflammation - diagnostic imaging Inflammation - drug therapy Inflammation - metabolism Lung - diagnostic imaging Lung - metabolism Lungs Metabolism Nitrogen Radioisotopes - administration & dosage Positive-Pressure Respiration - methods Positron-Emission Tomography - methods Pulmonary Surfactants - metabolism Radiopharmaceuticals - pharmacokinetics Respiration, Artificial - methods Sheep Stress, Mechanical Tomography Ventilation |
| title | Effects of surfactant depletion on regional pulmonary metabolic activity during mechanical ventilation |
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