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The Role of the Lactate Dehydrogenase and the Effect of Prone Position during Ventilator-induced Lung Injury

To examine the impact of lactate dehydrogenase (LDH) as an early marker of ventilator-induced lung injury (VILI) and the effect of prone position during the VILI, we ventilated 28 normal white rabbits (10 supine, 10 prone, 8 controls) for 6 hr or until PaO(2)/F(I)O(2) ratio was <200 mmHg. We appl...

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Detalles Bibliográficos
Autores principales: Lim, Sung Chul, Kim, Yu Il
Formato: Texto
Lenguaje:English
Publicado: The Korean Academy of Medical Sciences 2004
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2822303/
https://www.ncbi.nlm.nih.gov/pubmed/15082895
http://dx.doi.org/10.3346/jkms.2004.19.2.223
Descripción
Sumario:To examine the impact of lactate dehydrogenase (LDH) as an early marker of ventilator-induced lung injury (VILI) and the effect of prone position during the VILI, we ventilated 28 normal white rabbits (10 supine, 10 prone, 8 controls) for 6 hr or until PaO(2)/F(I)O(2) ratio was <200 mmHg. We applied an identical injurious ventilatory pattern (peak inspiratory pressure of 35 cmH(2)O with a PEEP of 3 cmH(2)O, I:E ratio of 1:2, and F(I)O(2) of 0.40) in the supine and prone group. VILI was assessed by oxygenation, gravimetric analysis and histologic grading. Serum levels of LDH progressively increased significantly during the VILI (supine and prone groups) as compared with controls. There was a significant negative correlation between oxygenation and LDH levels (r=-0.619, p<0.001). Wet weight/dry weight ratios (WW/DW) and histologic scores for dependent regions were significantly higher in the supine than the prone group. There were no differences in WW/DW and histologic scores for nondependent regions between the supine and prone group. These findings suggest that serum LDH levels might be an early marker of severity of lung injury. The prone position resulted in a less severe and more homogenous distribution of VILI.