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Intensive Care Medicine
Published in: Intensive Care Medicine 12/2007

01-12-2007 | Experimental

Effect of activated protein C on pulmonary blood flow and cytokine production in experimental acute lung injury

Authors: Jean-Christophe Richard, Fabienne Bregeon, Véronique Leray, Didier Le Bars, Nicolas Costes, Christian Tourvieille, Franck Lavenne, Mojgan Devouassoux-Shisheboran, Gerard Gimenez, Claude Guerin

Published in: Intensive Care Medicine | Issue 12/2007

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Abstract

Objective

In acute lung injury (ALI) activated protein C (APC) may reopen occluded lung vessels and minimize lung inflammation. We aimed at assessing the effect of APC on regional lung perfusion, aerated lung volume, cytokine production and oxygenation in experimental ALI.

Design and setting

Prospective, controlled study in an imaging facility.

Participants

Pigs tracheotomized and mechanically ventilated.

Intervention

Pigs were randomly given intravenously APC (n = 8) or saline (n = 8). Thirty minutes later, ALI was induced by injecting oleic acid.

Measurements and results

Lung perfusion and aerated lung volume measured with positron emission tomography, plasma cytokines and arterial blood gas were determined just before ALI and 110 and 290 min thereafter. Lung cytokines were measured at the end of the experiment. PaO2 under FIO2 1 was significantly lower in the APC group before lung injury (473 ± 129 vs. 578 ± 54 mmHg) and 110 min (342 ± 138 vs. 446 ± 103 mmHg) and 290 min (303 ± 171 vs. 547 ± 54 mmHg) thereafter (p < 0.05). Lung perfusion nonsignificantly tended to redistribute towards dorsal lung regions with APC. Total aerated lung volume was not different between APC and control before ALI (10.0 ± 1.5 vs. 11.0 ± 2.5 ml/kg) (p > 0.05) or thereafter. Plasma IL-6 and IL-8 at 110 min were greater with APC (p < 0.05).

Conclusions

In contrast to studies using other models, pretreatment with APC was associated with worsening oxygenation in the present investigation. This might be due to ventilation–perfusion mismatch, with more perfusion to dependent nonaerated areas.
Appendix
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Metadata
Title
Effect of activated protein C on pulmonary blood flow and cytokine production in experimental acute lung injury
Authors
Jean-Christophe Richard
Fabienne Bregeon
Véronique Leray
Didier Le Bars
Nicolas Costes
Christian Tourvieille
Franck Lavenne
Mojgan Devouassoux-Shisheboran
Gerard Gimenez
Claude Guerin
Publication date
01-12-2007
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 12/2007
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-007-0782-0

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