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CRITICAL CARE AND TRAUMA

Short-Term Administration of a High Oxygen Concentration Is Not Injurious in an Ex-Vivo Rabbit Model of Ventilator-Induced Lung Injury

Petros Kopterides, MD^*, Theodoros Kapetanakis, MD, Ilias I. Siempos, MD, Christina Magkou, MD, Aimilia Pelekanou, MD, Thomas Tsaganos, MD, Evangelos Giamarellos-Bourboulis, MD, Charis Roussos, MD^||, and Apostolos Armaganidis, MD^*

From the *Second Critical Care Department, Attiko University Hospital, University of Athens Medical School, Athens, Greece; Department of Experimental Surgery, Evangelismos Hospital, University of Athens Medical School, Athens, Greece; Department of Histopathology, Mitera Hospital, Athens, Greece; Fourth Department of Internal Medicine, Attiko University Hospital, University of Athens Medical School, Athens, Greece; and ||First Critical Care Department-Pulmonary Services, Evangelismos Hospital, University of Athens Medical School, Athens, Greece.

Address correspondence and reprint requests to Petros Kopterides, MD, 68 Kamaterou St, Kamatero–Athens 13451, Greece. Address e-mail to petkop{at}ath.forthnet.gr.

BACKGROUND: Mechanical ventilation and administration of a high oxygen concentration are simultaneously used in the management of respiratory failure. We conducted this study to evaluate the effect of a high inspired oxygen concentration on ventilator-induced lung injury.

METHODS: Forty sets of isolated/perfused rabbit lungs were randomized for 60 min of pressure-control ventilation at a plateau inspiratory pressure of 25 or 15 cm H₂O and positive end-expiratory pressure of 3 cm H₂O while receiving 100% or 21% O₂. The temperature, pH, and partial pressure of CO₂ in the perfusate were maintained the same in all groups (n = 10 for each group). The outcome measures used to assess lung injury included: the change in weight gain and ultrafiltration coefficient, the frequency of vascular failure, the histological lesions and the concentration of tumor necrosis factor- and malondialdehyde in the bronchoalveolar lavage fluid.

RESULTS: The two groups ventilated at the higher inspiratory pressure/tidal volume experienced greater weight gain and increases in the ultrafiltration coefficient, more frequently suffered vascular failure, and presented higher composite scores of histological damage than the two groups ventilated at the lower inspiratory pressure/tidal volume. Hyperoxia was not found to further increase any of the monitored markers of lung injury. No difference was noticed among the four experimental groups in the alveolar lavage fluid levels of tumor necrosis factor- or malondialdehyde.

CONCLUSIONS: These findings suggest that short-term administration of a high oxygen concentration is not a major determinant of ventilator-induced lung injury in this experimental model.