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Increased particle flow rate from airways precedes clinical signs of ARDS in a porcine model of LPS-induced acute lung injury

Stenlo, Martin LU ; Hyllén, Snejana LU ; Silva, Iran Augusto N LU orcid ; Bölükbas, Deniz A LU ; Pierre, Leif T LU ; Hallgren, Oskar LU ; Wagner, Darcy E LU orcid and Lindstedt, Sandra LU (2020) In American Journal of Physiology: Lung Cellular and Molecular Physiology 318(3). p.510-517
Abstract

Acute respiratory distress syndrome (ARDS) is a common cause of death in the intensive care unit, with mortality rates of ~30-40%. To reduce invasive diagnostics such as bronchoalveolar lavage and time-consuming in-hospital transports for imaging diagnostics, we hypothesized that particle flow rate (PFR) pattern from the airways could be an early detection method and contribute to improving diagnostics and optimizing personalized therapies. Porcine models were ventilated mechanically. Lipopolysaccharide (LPS) was administered endotracheally and in the pulmonary artery to induce ARDS. PFR was measured using a customized particles in exhaled air (PExA 2.0) device. In contrast to control animals undergoing mechanical ventilation and... (More)

Acute respiratory distress syndrome (ARDS) is a common cause of death in the intensive care unit, with mortality rates of ~30-40%. To reduce invasive diagnostics such as bronchoalveolar lavage and time-consuming in-hospital transports for imaging diagnostics, we hypothesized that particle flow rate (PFR) pattern from the airways could be an early detection method and contribute to improving diagnostics and optimizing personalized therapies. Porcine models were ventilated mechanically. Lipopolysaccharide (LPS) was administered endotracheally and in the pulmonary artery to induce ARDS. PFR was measured using a customized particles in exhaled air (PExA 2.0) device. In contrast to control animals undergoing mechanical ventilation and receiving saline administration, animals who received LPS developed ARDS according to clinical guidelines and histologic assessment. Plasma levels of TNF-α and IL-6 increased significantly compared with baseline after 120 and 180 min, respectively. On the other hand, the PFR significantly increased and peaked 60 min after LPS administration, i.e., ~30 min before any ARDS stage was observed with other well-established outcome measurements such as hypoxemia, increased inspiratory pressure, and lower tidal volumes or plasma cytokine levels. The present results imply that PFR could be used to detect early biomarkers or as a clinical indicator for the onset of ARDS.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
ARDS, LPS-induced lung injury, mechanical ventilation, particles in exhaled air
in
American Journal of Physiology: Lung Cellular and Molecular Physiology
volume
318
issue
3
pages
510 - 517
publisher
American Physiological Society
external identifiers
  • scopus:85081155814
  • pmid:31994907
ISSN
1522-1504
DOI
10.1152/ajplung.00524.2019
language
English
LU publication?
yes
id
e0cbae69-6aad-44e3-87d7-817c171a6733
date added to LUP
2020-02-12 11:11:40
date last changed
2024-06-13 11:37:50
@article{e0cbae69-6aad-44e3-87d7-817c171a6733,
  abstract     = {{<p>Acute respiratory distress syndrome (ARDS) is a common cause of death in the intensive care unit, with mortality rates of ~30-40%. To reduce invasive diagnostics such as bronchoalveolar lavage and time-consuming in-hospital transports for imaging diagnostics, we hypothesized that particle flow rate (PFR) pattern from the airways could be an early detection method and contribute to improving diagnostics and optimizing personalized therapies. Porcine models were ventilated mechanically. Lipopolysaccharide (LPS) was administered endotracheally and in the pulmonary artery to induce ARDS. PFR was measured using a customized particles in exhaled air (PExA 2.0) device. In contrast to control animals undergoing mechanical ventilation and receiving saline administration, animals who received LPS developed ARDS according to clinical guidelines and histologic assessment. Plasma levels of TNF-α and IL-6 increased significantly compared with baseline after 120 and 180 min, respectively. On the other hand, the PFR significantly increased and peaked 60 min after LPS administration, i.e., ~30 min before any ARDS stage was observed with other well-established outcome measurements such as hypoxemia, increased inspiratory pressure, and lower tidal volumes or plasma cytokine levels. The present results imply that PFR could be used to detect early biomarkers or as a clinical indicator for the onset of ARDS.</p>}},
  author       = {{Stenlo, Martin and Hyllén, Snejana and Silva, Iran Augusto N and Bölükbas, Deniz A and Pierre, Leif T and Hallgren, Oskar and Wagner, Darcy E and Lindstedt, Sandra}},
  issn         = {{1522-1504}},
  keywords     = {{ARDS; LPS-induced lung injury; mechanical ventilation; particles in exhaled air}},
  language     = {{eng}},
  month        = {{03}},
  number       = {{3}},
  pages        = {{510--517}},
  publisher    = {{American Physiological Society}},
  series       = {{American Journal of Physiology: Lung Cellular and Molecular Physiology}},
  title        = {{Increased particle flow rate from airways precedes clinical signs of ARDS in a porcine model of LPS-induced acute lung injury}},
  url          = {{http://dx.doi.org/10.1152/ajplung.00524.2019}},
  doi          = {{10.1152/ajplung.00524.2019}},
  volume       = {{318}},
  year         = {{2020}},
}