TY - JOUR
T1 - A long-lasting porcine model of ARDS caused by pneumonia and ventilator-induced lung injury
AU - Barbeta, Enric
AU - Arrieta, Marta
AU - Motos, Ana
AU - Bobi, Joaquim
AU - Yang, Hua
AU - Yang, Minlan
AU - Tanzella, Giacomo
AU - Di Ginnatale, Pierluigi
AU - Nogas, Stefano
AU - Vargas, Carmen Rosa
AU - Cabrera, Roberto
AU - Battaglini, Denise
AU - Meli, Andrea
AU - Kiarostami, Kasra
AU - Vázquez, Nil
AU - Fernández-Barat, Laia
AU - Rigol, Montserrat
AU - Mellado-Artigas, Ricard
AU - Frigola, Gerard
AU - Camprubí-Rimblas, Marta
AU - Ferrer, Pau
AU - Martinez, Daniel
AU - Artigas Raventós, Antoni
AU - Ferrando, Carlos
AU - Ferrer, Miquel
AU - Torres, Antoni
N1 - Publisher Copyright:
© 2023, The Author(s).
PY - 2023/12
Y1 - 2023/12
N2 - BACKGROUND: Animal models of acute respiratory distress syndrome (ARDS) do not completely resemble human ARDS, struggling translational research. We aimed to characterize a porcine model of ARDS induced by pneumonia-the most common risk factor in humans-and analyze the additional effect of ventilator-induced lung injury (VILI).METHODS: Bronchoscopy-guided instillation of a multidrug-resistant Pseudomonas aeruginosa strain was performed in ten healthy pigs. In six animals (pneumonia-with-VILI group), pulmonary damage was further increased by VILI applied 3 h before instillation and until ARDS was diagnosed by PaO
2/FiO
2 < 150 mmHg. Four animals (pneumonia-without-VILI group) were protectively ventilated 3 h before inoculum and thereafter. Gas exchange, respiratory mechanics, hemodynamics, microbiological studies and inflammatory markers were analyzed during the 96-h experiment. During necropsy, lobar samples were also analyzed.
RESULTS: All animals from pneumonia-with-VILI group reached Berlin criteria for ARDS diagnosis until the end of experiment. The mean duration under ARDS diagnosis was 46.8 ± 7.7 h; the lowest PaO
2/FiO
2 was 83 ± 5.45 mmHg. The group of pigs that were not subjected to VILI did not meet ARDS criteria, even when presenting with bilateral pneumonia. Animals developing ARDS presented hemodynamic instability as well as severe hypercapnia despite high-minute ventilation. Unlike the pneumonia-without-VILI group, the ARDS animals presented lower static compliance (p = 0.011) and increased pulmonary permeability (p = 0.013). The highest burden of P. aeruginosa was found at pneumonia diagnosis in all animals, as well as a high inflammatory response shown by a release of interleukin (IL)-6 and IL-8. At histological examination, only animals comprising the pneumonia-with-VILI group presented signs consistent with diffuse alveolar damage.
CONCLUSIONS: In conclusion, we established an accurate pulmonary sepsis-induced ARDS model.
AB - BACKGROUND: Animal models of acute respiratory distress syndrome (ARDS) do not completely resemble human ARDS, struggling translational research. We aimed to characterize a porcine model of ARDS induced by pneumonia-the most common risk factor in humans-and analyze the additional effect of ventilator-induced lung injury (VILI).METHODS: Bronchoscopy-guided instillation of a multidrug-resistant Pseudomonas aeruginosa strain was performed in ten healthy pigs. In six animals (pneumonia-with-VILI group), pulmonary damage was further increased by VILI applied 3 h before instillation and until ARDS was diagnosed by PaO
2/FiO
2 < 150 mmHg. Four animals (pneumonia-without-VILI group) were protectively ventilated 3 h before inoculum and thereafter. Gas exchange, respiratory mechanics, hemodynamics, microbiological studies and inflammatory markers were analyzed during the 96-h experiment. During necropsy, lobar samples were also analyzed.
RESULTS: All animals from pneumonia-with-VILI group reached Berlin criteria for ARDS diagnosis until the end of experiment. The mean duration under ARDS diagnosis was 46.8 ± 7.7 h; the lowest PaO
2/FiO
2 was 83 ± 5.45 mmHg. The group of pigs that were not subjected to VILI did not meet ARDS criteria, even when presenting with bilateral pneumonia. Animals developing ARDS presented hemodynamic instability as well as severe hypercapnia despite high-minute ventilation. Unlike the pneumonia-without-VILI group, the ARDS animals presented lower static compliance (p = 0.011) and increased pulmonary permeability (p = 0.013). The highest burden of P. aeruginosa was found at pneumonia diagnosis in all animals, as well as a high inflammatory response shown by a release of interleukin (IL)-6 and IL-8. At histological examination, only animals comprising the pneumonia-with-VILI group presented signs consistent with diffuse alveolar damage.
CONCLUSIONS: In conclusion, we established an accurate pulmonary sepsis-induced ARDS model.
KW - Ards
KW - Double hit
KW - Injurious mechanical ventilation
KW - Pneumonia
KW - Porcine model
KW - Ventilator-induced lung injury
UR - http://www.scopus.com/inward/record.url?scp=85162719043&partnerID=8YFLogxK
UR - https://www.mendeley.com/catalogue/0c9b0acd-f43a-31b8-b097-eb1b539528a2/
U2 - 10.1186/s13054-023-04512-8
DO - 10.1186/s13054-023-04512-8
M3 - Article
C2 - 37328874
SN - 1466-609X
VL - 27
JO - Critical Care
JF - Critical Care
IS - 1
M1 - 239
ER -
