@article{oai:jrckicn.repo.nii.ac.jp:00000841,
 author = {KAMIYAMA, Junko and 神山, 純子 and Jesmin, Subrina and 荒井, サブリナ and SAKURAMOTO, Hideaki and 櫻本, 秀明 and SIMOJO, Nobutake and 下條, 信威 and Islam, Majedul and 萩谷, 圭一 and HAGIYA, Keiichi and 菅野, 雅人 and SUGANO, Masato and UNOKI, Takeshi and 卯野木, 健 and OKI, Masami and KAWANO, Satoru and 河野, 了 and MIZUTANI, Taro and 水谷, 太郎},
 issue = {15},
 journal = {BMC anesthesiology},
 month = {May},
 note = {application/pdf, Background
Hyperinflation (HI) is performed following open endotracheal suctioning (OES), whose goals include: to stimulate a cough, recover oxygenation and improve compliance. However, it may also induce unintended consequences, including: lung stress and strain, failure to maintain high distending pressure, and subsequently cycling recruitment and derecruitment. Here, our aim was to investigate the effects of hyperinflation after repeated OES on sequential alteration of arterial oxygenation and lung injury profile using a saline lavage-induced surfactant depleted ARDS rabbit model.

Methods
Briefly, 30 Japanese White Rabbits were anesthetized and ventilated in pressure-controlled setting with a tidal volume of 6-8 ml/kg. Animals were divided into four groups, i.e.; Control, ARDS, OES, and HI. Saline-lavage-induced lung injury was induced except for Control group. Thereafter, rabbits were ventilated with positive-end expiratory pressure (PEEP) at 10 cm H2O. The ARDS group received ventilation with the same PEEP without derecruitment. As intervention, OES and HI were performed in ARDS animals. OES was performed for 15 seconds at 150 mm Hg, whereas HI was performed with PEEP at 0 cm H2O and peak inspiratory pressure at +5 cm H2O for a minute. Total duration of the experiment was for 3 hours. OES and HI were performed every 15 minutes from beginning of the protocol.

Results
PaO2 was maintained at about 400 mm Hg in both control and ARDS groups for the duration of this study, while in both OES and HI groups, PaO2 decreased continuously up to 3 hours, dropped to a mean (±SD) of 226 ± 28.9 and 97.0 ± 30.7 mmHg at 3 h, respectively. HI group had the lowest PaO2 in the present investigation. Histological lung injury score was the highest in HI group than other three groups. Pulmonary TNF-α and IL-8 levels were the highest in HI group compared to other groups, but without significant alterations at circulatory level in all the experimental groups.

Conclusions
We show in the present study that hyperinflation following repeated OES deteriorate arterial oxygenation and the severity of lung injury in a rabbit model of ARDS undergoing mechanical ventilation., Research article},
 title = {Hyperinflation deteriorates arterial oxygenation and lung injury in a rabbit model of ARDS with repeated open endotracheal suctioning},
 year = {2015},
 yomi = {カミヤマ, ジュンコ and アライ, サブリナ and サクラモト, ヒデアキ and シモジョウ, ノブタケ and ハギヤ, ケイイチ and スガノ, マサト and ウノキ, タケシ and カワノ, サトル and ミズタニ, タロウ}
}