Mild hypothermia attenuate kidney injury in canines with oleic acid-induced acute respiratory distress syndrome

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• 作者：Jingen Xia^a ; ¹ ; ² ; ^{xiajingen_00632@163.com" class="auth_mail" title="E-mail the corresponding author} ; Ran Li^b ; ¹ ; ³ ; ^{liran1987319@163.com" class="auth_mail" title="E-mail the corresponding author} ; Rui Yang^b ; ³ ; ^{graceful_angle@163.com" class="auth_mail" title="E-mail the corresponding author} ; Li Zhang^b ; ³ ; ^{zhangli-1983@163.com" class="auth_mail" title="E-mail the corresponding author} ; Bing Sun^b ; ³ ; ^{ricusunbing@126.com" class="auth_mail" title="E-mail the corresponding author} ; Yingying Feng^a ; ² ; ^{daisel@163.com" class="auth_mail" title="E-mail the corresponding author} ; Jingjing Jin^b ; ³ ; ^{13811509017@163.com" class="auth_mail" title="E-mail the corresponding author} ; Linna Huang^b ; ³ ; ^{xuehuaalice@126.com" class="auth_mail" title="E-mail the corresponding author} ; Qingyuan Zhan^a ; ^{drzhanqy@163.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Hypothermia ; Acute respiratory distress syndrome ; Ventilator induced-lung injury ; Mechanical ventilation ; Multiple organs failure ; Kidney injury
• 刊名：Injury
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：47
• 期：7
• 页码：1445-1451
• 全文大小：976 K

文摘

Hypothermia may attenuate ventilator induced-lung injury in acute respiratory distress syndrome (ARDS). However, the impact of hypothermia on extra-pulmonary organ injury in ARDS remains unclear. The purpose of this study was to investigate whether hypothermia affects extra-pulmonary organ injury in a canine ARDS model induced by oleic acid.

Objectives

Twelve anesthetized canines with oleic acid-induced ARDS were randomly divided (n = 6 per group) into a hypothermia group (core temperature of 33 ± 1 °C, HT group) and a normothermia group (core temperature of 38 ± 1 °C, NT group) and treated for four hours. The liver, small intestine and kidney were assessed by evaluating biochemical parameters, plasma and tissue cytokine levels, and tissue histopathological injury scores.

Results

The HT group showed a lower plateau pressure, lung elastance and pulmonary vascular resistance. Hypothermia was associated with lower oxygen consumption (138.4 ± 55.0 ml min⁻¹vs. 72.0 ± 11.2 ml min⁻¹, P < 0.05) and higher oxygen saturation of mixed venous blood (62.8% ± 8.0% vs. 77.5% ± 10.1%, P < 0.05). Both groups had similar levels of tumour necrosis factor-α in the plasma and extra-pulmonary organ, however, plasma interleukin-10 (97.1 ± 25.0 pg ml⁻¹vs. 131.4 ± 27.0 pg ml⁻¹, P < 0.05) was higher in the HT group. Further, the animals in the HT group had a lower levels of plasma creatinine (54.6 ± 19.1 U L⁻¹vs. 29.1 ± 8.0 U L⁻¹, P < 0.05), and lower renal histopathological injury scores [4.0(3.5;7.0) vs. 1.5(0.8;3.0), P < 0.05]. Hypothermia did not affect the histopathological injury of the liver and small intestine.

Conclusions

Short-term mild hypothermia can reduce lung elastance and pulmonary vascular resistance, increase the systemic anti-inflammatory response and attenuate kidney histopathological injury in a canine ARDS model induced by oleic acid.