Effects of the Prone Position on Regional Neutrophilic Lung Inflammation According to 18F-FDG Pet in an Experimental Ventilator-Induced Lung Injury Model
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- Susumu Nakahashi
- Department of Emergency and Critical Care Center, Mie University Hospital, Tsu, Japan
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- Hiroshi Imai
- Department of Emergency and Critical Care Center, Mie University Hospital, Tsu, Japan
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- Nobutake Shimojo
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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- Yasuhiro Magata
- Department of Molecular Imaging, Institute for Medical Photonics Research, Hamamatsu University School of Medicine, Hamamatsu, Japan
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- Takahiro Einama
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
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- Mineji Hayakawa
- Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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- Takeshi Wada
- Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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- Yuji Morimoto
- Division of Anesthesia and Perioperative Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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- Satoshi Gando
- Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
説明
<jats:sec> <jats:title>ABSTRACT</jats:title> <jats:p>Ventilator-induced lung injury (VILI) can be life-threatening and it is important to prevent the development of VILI. It remains unclear whether the prone position affects neutrophilic inflammation in the lung regions <jats:italic toggle="yes">in vivo</jats:italic>, which plays a crucial role in the pathogenesis of VILI. This study aimed to assess the relationship between the use of the prone position and the development of VILI-associated regional neutrophilic lung inflammation. Regional neutrophilic lung inflammation and lung aeration during low tidal volume mechanical ventilation were assessed using <jats:italic toggle="yes">in vivo</jats:italic> 2-deoxy-2-[(18)F] fluoro-D-glucose (<jats:sup>18</jats:sup>F-FDG) positron emission tomography and computed tomography in acutely experimentally injured rabbit lungs (lung injury induced by lung lavage and excessive ventilation). Direct comparisons were made among three groups: control, supine, and prone positions. After approximately 7 h, tissue-normalized <jats:sup>18</jats:sup>F-FDG uptake differed significantly between the supine and prone positions (SUP: 0.038 ± 0.014 vs. PP: 0.029 ± 0.008, <jats:italic toggle="yes">P</jats:italic> = 0.038), especially in the ventral region (SUP: 0.052 ± 0.013 vs. PP: 0.026 ± 0.007, <jats:italic toggle="yes">P</jats:italic> = 0.003). The use of the prone position reduced lung inhomogeneities, which was demonstrated by the correction of the disproportionate rate of voxel gas over the given lung region. The progression of neutrophilic inflammation was affected by the interaction between the total strain (for aeration) and the inhomogeneity. The prone position is effective in slowing down the progression of VILI-associated neutrophilic inflammation. Under low-tidal-volume ventilation, the main drivers of its effect may be homogenization of lung tissue and that of mechanical forces.</jats:p> </jats:sec>
収録刊行物
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- Shock
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Shock 57 (2), 298-308, 2021-06-08
Ovid Technologies (Wolters Kluwer Health)
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詳細情報 詳細情報について
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- CRID
- 1360861705580515840
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- ISSN
- 15400514
- 10732322
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- データソース種別
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- Crossref
- KAKEN