Experimental ventilator-associated pneumonia: distribution of lung infection and consequences for lung aeration

Ventilator-associated pneumonia (VAP) has been described in humans and in experimental animals. The most severe lesions are located in dependent lung segments along a sterno-vertebral axis, however the cephalocaudal distribution of lung infection remains unknown. We used an experimental model to eva...

Full description

Bibliographic Details
Main Authors: Silvia Regina Rios Vieira, Ivan Goldstein, Gilles Lenaour, Charles-Hugo Marquette, Jean-Jacques Rouby
Format: Article
Language:English
Published: Elsevier
Series:Brazilian Journal of Infectious Diseases
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702003000300007&lng=en&tlng=en
id doaj-67aa40dd44df47f482af401a507a745f
record_format Article
spelling doaj-67aa40dd44df47f482af401a507a745f2020-11-25T03:48:04ZengElsevierBrazilian Journal of Infectious Diseases1678-43917321622310.1590/S1413-86702003000300007S1413-86702003000300007Experimental ventilator-associated pneumonia: distribution of lung infection and consequences for lung aerationSilvia Regina Rios VieiraIvan GoldsteinGilles LenaourCharles-Hugo MarquetteJean-Jacques RoubyVentilator-associated pneumonia (VAP) has been described in humans and in experimental animals. The most severe lesions are located in dependent lung segments along a sterno-vertebral axis, however the cephalocaudal distribution of lung infection remains unknown. We used an experimental model to evaluate the distribution of lung infection, considering its anteroposterior and cephalocaudal gradient, and its impact on lung aeration. Ten healthy domestic piglets were anesthetized, paralyzed and mechanically ventilated for 59 hours in the prone position. At the end of the experiment they were sacrificed and their lungs were fixed. Six segments were analyzed: a non-dependant (ND) and a dependant (D) segment of the upper (UL), middle (ML) and lower (LL) lobes. The presence of healthy lung or of histological infectious lesions was analyzed with a semi-quantitative method. The regional distribution of lung infection was compared between upper, middle and lower lobes, as well as between dependant and non-dependant regions. The presence of infectious lesions was correlated with measurements of lung aeration. Nine of the ten piglets developed VAP. Infectious lesions were distributed along a sterno-vertebral and a cephalocaudal gradient; the lower and middle lobes were more frequently infected than the upper lobes. There was an inverse correlation (R= - 0.902) between the development of lung lesions and lung aeration. In conclusion, VAP was a frequent complication in healthy mechanically ventilated piglets, showing an anteroposterior as well as a cephalocaudal gradient. As expected, development of lung infection was accompanied by a corresponding loss of aeration.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702003000300007&lng=en&tlng=enVentilator associated pneumonia
collection DOAJ
language English
format Article
sources DOAJ
author Silvia Regina Rios Vieira
Ivan Goldstein
Gilles Lenaour
Charles-Hugo Marquette
Jean-Jacques Rouby
spellingShingle Silvia Regina Rios Vieira
Ivan Goldstein
Gilles Lenaour
Charles-Hugo Marquette
Jean-Jacques Rouby
Experimental ventilator-associated pneumonia: distribution of lung infection and consequences for lung aeration
Brazilian Journal of Infectious Diseases
Ventilator associated pneumonia
author_facet Silvia Regina Rios Vieira
Ivan Goldstein
Gilles Lenaour
Charles-Hugo Marquette
Jean-Jacques Rouby
author_sort Silvia Regina Rios Vieira
title Experimental ventilator-associated pneumonia: distribution of lung infection and consequences for lung aeration
title_short Experimental ventilator-associated pneumonia: distribution of lung infection and consequences for lung aeration
title_full Experimental ventilator-associated pneumonia: distribution of lung infection and consequences for lung aeration
title_fullStr Experimental ventilator-associated pneumonia: distribution of lung infection and consequences for lung aeration
title_full_unstemmed Experimental ventilator-associated pneumonia: distribution of lung infection and consequences for lung aeration
title_sort experimental ventilator-associated pneumonia: distribution of lung infection and consequences for lung aeration
publisher Elsevier
series Brazilian Journal of Infectious Diseases
issn 1678-4391
description Ventilator-associated pneumonia (VAP) has been described in humans and in experimental animals. The most severe lesions are located in dependent lung segments along a sterno-vertebral axis, however the cephalocaudal distribution of lung infection remains unknown. We used an experimental model to evaluate the distribution of lung infection, considering its anteroposterior and cephalocaudal gradient, and its impact on lung aeration. Ten healthy domestic piglets were anesthetized, paralyzed and mechanically ventilated for 59 hours in the prone position. At the end of the experiment they were sacrificed and their lungs were fixed. Six segments were analyzed: a non-dependant (ND) and a dependant (D) segment of the upper (UL), middle (ML) and lower (LL) lobes. The presence of healthy lung or of histological infectious lesions was analyzed with a semi-quantitative method. The regional distribution of lung infection was compared between upper, middle and lower lobes, as well as between dependant and non-dependant regions. The presence of infectious lesions was correlated with measurements of lung aeration. Nine of the ten piglets developed VAP. Infectious lesions were distributed along a sterno-vertebral and a cephalocaudal gradient; the lower and middle lobes were more frequently infected than the upper lobes. There was an inverse correlation (R= - 0.902) between the development of lung lesions and lung aeration. In conclusion, VAP was a frequent complication in healthy mechanically ventilated piglets, showing an anteroposterior as well as a cephalocaudal gradient. As expected, development of lung infection was accompanied by a corresponding loss of aeration.
topic Ventilator associated pneumonia
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702003000300007&lng=en&tlng=en
work_keys_str_mv AT silviareginariosvieira experimentalventilatorassociatedpneumoniadistributionoflunginfectionandconsequencesforlungaeration
AT ivangoldstein experimentalventilatorassociatedpneumoniadistributionoflunginfectionandconsequencesforlungaeration
AT gilleslenaour experimentalventilatorassociatedpneumoniadistributionoflunginfectionandconsequencesforlungaeration
AT charleshugomarquette experimentalventilatorassociatedpneumoniadistributionoflunginfectionandconsequencesforlungaeration
AT jeanjacquesrouby experimentalventilatorassociatedpneumoniadistributionoflunginfectionandconsequencesforlungaeration
_version_ 1724500462262026240