Appraisal of systemic inflammation and diagnostic markers in a porcine model of VAP
| Autor(a) principal: | |
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| Data de Publicação: | 2018 |
| Outros Autores: | , , , , , , , , , , , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
| Texto Completo: | http://hdl.handle.net/10362/141373 |
Resumo: | Funding: Support was provided by the Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Ministerio de Ciencia e Innovación (PS09/01249); European Society of Intensive Care Medicine-ESICM (2009 Alain Harf Award on Applied Respiratory Physiology); Fundació Catalana de Pneumologıa (FUCAP); Sociedad Española de Neumología y Cirugía Torácica (SEPAR); Centro de Investigación Biomedica En Red-Enfermedades Respiratorias, (CIBERES). |
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Appraisal of systemic inflammation and diagnostic markers in a porcine model of VAPsecondary analysis from a study on novel preventive strategiesInflammationInterleukinMechanical ventilationSemirecumbentTrendelenburgVentilator-associated pneumoniaCritical Care and Intensive Care MedicineEmergency MedicinePhysiology (medical)Funding: Support was provided by the Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Ministerio de Ciencia e Innovación (PS09/01249); European Society of Intensive Care Medicine-ESICM (2009 Alain Harf Award on Applied Respiratory Physiology); Fundació Catalana de Pneumologıa (FUCAP); Sociedad Española de Neumología y Cirugía Torácica (SEPAR); Centro de Investigación Biomedica En Red-Enfermedades Respiratorias, (CIBERES).Background: We previously evaluated the efficacy of a ventilatory strategy to achieve expiratory flow bias and positive end-expiratory pressure (EFB + PEEP) or the Trendelenburg position (TP) for the prevention of ventilator-associated pneumonia (VAP). These preventive measures were aimed at improving mucus clearance and reducing pulmonary aspiration of bacteria-laden oropharyngeal secretions. This secondary analysis is aimed at evaluating the effects of aforementioned interventions on systemic inflammation and to substantiate the value of clinical parameters and cytokines in the diagnosis of VAP. Methods: Twenty female pigs were randomized to be positioned in the semirecumbent/prone position, and ventilated with duty cycle 0.33 and without PEEP (control); positioned as in the control group, PEEP 5 cmH2O, and duty cycle to achieve expiratory flow bias (EFB+PEEP); ventilated as in the control group, but in the Trendelenburg position (Trendelenburg). Following randomization, P. aeruginosa was instilled into the oropharynx. Systemic cytokines and tracheal secretions P. aeruginosa concentration were quantified every 24h. Lung biopsies were collected for microbiological confirmation of VAP. Results: In the control, EFB + PEEP, and Trendelenburg groups, lung tissue Pseudomonas aeruginosa concentration was 2.4 ± 1.5, 1.9 ± 2.1, and 0.3 ± 0.6 log cfu/mL, respectively (p = 0.020). Whereas, it was 2.4 ± 1.9 and 0.6 ± 0.9 log cfu/mL in animals with or without VAP (p < 0.001). Lower levels of interleukin (IL)-1β (p = 0.021), IL-1RA (p < 0.001), IL-4 (p = 0.005), IL-8 (p = 0.008), and IL-18 (p = 0.050) were found in Trendelenburg animals. VAP increased IL-10 (p = 0.035), tumor necrosis factor-α (p = 0.041), and endotracheal aspirate (ETA) P. aeruginosa concentration (p = 0.024). A model comprising ETA bacterial burden, IL-10, and TNF-α yielded moderate discrimination for the diagnosis of VAP (area of the receiver operating curve 0.82, 95% CI 0.61–1.00). Conclusions: Our findings demonstrate anti-inflammatory effects associated with the Trendelenburg position. In this reliable model of VAP, ETA culture showed good diagnostic accuracy, whereas systemic IL-10 and TNF-α marginally improved accuracy. Further clinical studies will be necessary to confirm clinical value of the Trendelenburg position as a measure to hinder inflammation during mechanical ventilation and significance of systemic IL-10 and TNF-α in the diagnosis of VAP.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)Centro de Estudos de Doenças Crónicas (CEDOC)RUNLi Bassi, GianluigiPrats, Raquel GuillamatArtigas, AntonioXiol, Eli AguileraMarti, Joan DanielRanzani, Otavio T.Rigol, MontserratFernandez, LaiaMeli, AndreaBattaglini, DeniseLuque, NestorFerrer, MiguelMartin-Loeches, IgnacioPóvoa, PedroChiumello, DavidePelosi, PaoloTorres, Antoni2022-07-04T22:24:25Z2018-12-012018-12-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/141373eng2197-425XPURE: 45131542https://doi.org/10.1186/s40635-018-0206-1info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T05:18:45Zoai:run.unl.pt:10362/141373Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:49:58.757298Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
| dc.title.none.fl_str_mv |
Appraisal of systemic inflammation and diagnostic markers in a porcine model of VAP secondary analysis from a study on novel preventive strategies |
| title |
Appraisal of systemic inflammation and diagnostic markers in a porcine model of VAP |
| spellingShingle |
Appraisal of systemic inflammation and diagnostic markers in a porcine model of VAP Li Bassi, Gianluigi Inflammation Interleukin Mechanical ventilation Semirecumbent Trendelenburg Ventilator-associated pneumonia Critical Care and Intensive Care Medicine Emergency Medicine Physiology (medical) |
| title_short |
Appraisal of systemic inflammation and diagnostic markers in a porcine model of VAP |
| title_full |
Appraisal of systemic inflammation and diagnostic markers in a porcine model of VAP |
| title_fullStr |
Appraisal of systemic inflammation and diagnostic markers in a porcine model of VAP |
| title_full_unstemmed |
Appraisal of systemic inflammation and diagnostic markers in a porcine model of VAP |
| title_sort |
Appraisal of systemic inflammation and diagnostic markers in a porcine model of VAP |
| author |
Li Bassi, Gianluigi |
| author_facet |
Li Bassi, Gianluigi Prats, Raquel Guillamat Artigas, Antonio Xiol, Eli Aguilera Marti, Joan Daniel Ranzani, Otavio T. Rigol, Montserrat Fernandez, Laia Meli, Andrea Battaglini, Denise Luque, Nestor Ferrer, Miguel Martin-Loeches, Ignacio Póvoa, Pedro Chiumello, Davide Pelosi, Paolo Torres, Antoni |
| author_role |
author |
| author2 |
Prats, Raquel Guillamat Artigas, Antonio Xiol, Eli Aguilera Marti, Joan Daniel Ranzani, Otavio T. Rigol, Montserrat Fernandez, Laia Meli, Andrea Battaglini, Denise Luque, Nestor Ferrer, Miguel Martin-Loeches, Ignacio Póvoa, Pedro Chiumello, Davide Pelosi, Paolo Torres, Antoni |
| author2_role |
author author author author author author author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) Centro de Estudos de Doenças Crónicas (CEDOC) RUN |
| dc.contributor.author.fl_str_mv |
Li Bassi, Gianluigi Prats, Raquel Guillamat Artigas, Antonio Xiol, Eli Aguilera Marti, Joan Daniel Ranzani, Otavio T. Rigol, Montserrat Fernandez, Laia Meli, Andrea Battaglini, Denise Luque, Nestor Ferrer, Miguel Martin-Loeches, Ignacio Póvoa, Pedro Chiumello, Davide Pelosi, Paolo Torres, Antoni |
| dc.subject.por.fl_str_mv |
Inflammation Interleukin Mechanical ventilation Semirecumbent Trendelenburg Ventilator-associated pneumonia Critical Care and Intensive Care Medicine Emergency Medicine Physiology (medical) |
| topic |
Inflammation Interleukin Mechanical ventilation Semirecumbent Trendelenburg Ventilator-associated pneumonia Critical Care and Intensive Care Medicine Emergency Medicine Physiology (medical) |
| description |
Funding: Support was provided by the Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Ministerio de Ciencia e Innovación (PS09/01249); European Society of Intensive Care Medicine-ESICM (2009 Alain Harf Award on Applied Respiratory Physiology); Fundació Catalana de Pneumologıa (FUCAP); Sociedad Española de Neumología y Cirugía Torácica (SEPAR); Centro de Investigación Biomedica En Red-Enfermedades Respiratorias, (CIBERES). |
| publishDate |
2018 |
| dc.date.none.fl_str_mv |
2018-12-01 2018-12-01T00:00:00Z 2022-07-04T22:24:25Z |
| dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
| dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10362/141373 |
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http://hdl.handle.net/10362/141373 |
| dc.language.iso.fl_str_mv |
eng |
| language |
eng |
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2197-425X PURE: 45131542 https://doi.org/10.1186/s40635-018-0206-1 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
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