The fall in exhaled nitric oxide with ventilation at low lung volumes in rabbits

An index of small airway injury

Edgardo D'Angelo, Nickolaus G. Koulouris, Patrizia Della Valle, Guendalina Gentile, Matteo Pecchiari

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

The mechanisms involved in the fall of exhaled nitric oxide (NOe) concentration occurring in normal, anesthetized open chest rabbits with prolonged mechanical ventilation (MV) at low lung volume have been investigated. NOe, pH of exhaled vapor condensate, serum prostaglandin E 2, and F , tumor necrosis factor (TNF-α), PaO 2, PaCO 2, pHa, and lung mechanics were assessed before, during, and after 3-4 h of MV at zero end-expiratory pressure (ZEEP), with fixed tidal volume (9 ml kg -1) and frequency, as well as before and after 3-4 h of MV on PEEP only. Lung histology and wet-to-dry ratio (W/D), and prostaglandin and TNF-α in bronchoalveolar lavage fluid (BALF) were also assessed. While MV on PEEP had no effect on the parameters above, MV on ZEEP caused a marked fall (45%) of NOe, with a persistent increase of airway resistance (45%) and lung elastance (12%). Changes in NOe were independent of prostaglandin and TNF-α levels, systemic hypoxia, hypercapnia and acidosis, bronchiolar and alveolar interstitial edema, and pH of exhaled vapor condensate. In contrast, there was a significant relationship between the decrease in NOe and bronchiolar epithelial injury score. This indicates that the fall in NOe, which occurs in the absence of an inflammatory response, is due to the epithelial damage caused by the abnormal stresses related to cyclic opening and closing of small airways with MV on ZEEP, and suggests its use as a sign of peripheral airway injury.

Original languageEnglish
Pages (from-to)215-223
Number of pages9
JournalRespiratory Physiology and Neurobiology
Volume160
Issue number2
DOIs
Publication statusPublished - Feb 1 2008

Fingerprint

Artificial Respiration
Ventilation
Nitric Oxide
Rabbits
Lung
Wounds and Injuries
Tumor Necrosis Factor-alpha
Pressure
Prostaglandins D
Airway Resistance
Hypercapnia
Tidal Volume
Bronchoalveolar Lavage Fluid
Prostaglandins F
Pulmonary Edema
Acidosis
Prostaglandins E
Mechanics
Prostaglandins
Edema

Keywords

  • Low volume ventilation
  • Lung mechanics
  • Nitric oxide
  • Prostaglandins
  • Small airway injury

ASJC Scopus subject areas

  • Physiology
  • Pulmonary and Respiratory Medicine
  • Neuroscience(all)

Cite this

The fall in exhaled nitric oxide with ventilation at low lung volumes in rabbits : An index of small airway injury. / D'Angelo, Edgardo; Koulouris, Nickolaus G.; Della Valle, Patrizia; Gentile, Guendalina; Pecchiari, Matteo.

In: Respiratory Physiology and Neurobiology, Vol. 160, No. 2, 01.02.2008, p. 215-223.

Research output: Contribution to journalArticle

D'Angelo, Edgardo ; Koulouris, Nickolaus G. ; Della Valle, Patrizia ; Gentile, Guendalina ; Pecchiari, Matteo. / The fall in exhaled nitric oxide with ventilation at low lung volumes in rabbits : An index of small airway injury. In: Respiratory Physiology and Neurobiology. 2008 ; Vol. 160, No. 2. pp. 215-223.
@article{2874078f486046d6b2f49e94978b9d3e,
title = "The fall in exhaled nitric oxide with ventilation at low lung volumes in rabbits: An index of small airway injury",
abstract = "The mechanisms involved in the fall of exhaled nitric oxide (NOe) concentration occurring in normal, anesthetized open chest rabbits with prolonged mechanical ventilation (MV) at low lung volume have been investigated. NOe, pH of exhaled vapor condensate, serum prostaglandin E 2, and F 2α, tumor necrosis factor (TNF-α), PaO 2, PaCO 2, pHa, and lung mechanics were assessed before, during, and after 3-4 h of MV at zero end-expiratory pressure (ZEEP), with fixed tidal volume (9 ml kg -1) and frequency, as well as before and after 3-4 h of MV on PEEP only. Lung histology and wet-to-dry ratio (W/D), and prostaglandin and TNF-α in bronchoalveolar lavage fluid (BALF) were also assessed. While MV on PEEP had no effect on the parameters above, MV on ZEEP caused a marked fall (45{\%}) of NOe, with a persistent increase of airway resistance (45{\%}) and lung elastance (12{\%}). Changes in NOe were independent of prostaglandin and TNF-α levels, systemic hypoxia, hypercapnia and acidosis, bronchiolar and alveolar interstitial edema, and pH of exhaled vapor condensate. In contrast, there was a significant relationship between the decrease in NOe and bronchiolar epithelial injury score. This indicates that the fall in NOe, which occurs in the absence of an inflammatory response, is due to the epithelial damage caused by the abnormal stresses related to cyclic opening and closing of small airways with MV on ZEEP, and suggests its use as a sign of peripheral airway injury.",
keywords = "Low volume ventilation, Lung mechanics, Nitric oxide, Prostaglandins, Small airway injury",
author = "Edgardo D'Angelo and Koulouris, {Nickolaus G.} and {Della Valle}, Patrizia and Guendalina Gentile and Matteo Pecchiari",
year = "2008",
month = "2",
day = "1",
doi = "10.1016/j.resp.2007.10.001",
language = "English",
volume = "160",
pages = "215--223",
journal = "Respiratory Physiology and Neurobiology",
issn = "1569-9048",
publisher = "Elsevier",
number = "2",

}

TY - JOUR

T1 - The fall in exhaled nitric oxide with ventilation at low lung volumes in rabbits

T2 - An index of small airway injury

AU - D'Angelo, Edgardo

AU - Koulouris, Nickolaus G.

AU - Della Valle, Patrizia

AU - Gentile, Guendalina

AU - Pecchiari, Matteo

PY - 2008/2/1

Y1 - 2008/2/1

N2 - The mechanisms involved in the fall of exhaled nitric oxide (NOe) concentration occurring in normal, anesthetized open chest rabbits with prolonged mechanical ventilation (MV) at low lung volume have been investigated. NOe, pH of exhaled vapor condensate, serum prostaglandin E 2, and F 2α, tumor necrosis factor (TNF-α), PaO 2, PaCO 2, pHa, and lung mechanics were assessed before, during, and after 3-4 h of MV at zero end-expiratory pressure (ZEEP), with fixed tidal volume (9 ml kg -1) and frequency, as well as before and after 3-4 h of MV on PEEP only. Lung histology and wet-to-dry ratio (W/D), and prostaglandin and TNF-α in bronchoalveolar lavage fluid (BALF) were also assessed. While MV on PEEP had no effect on the parameters above, MV on ZEEP caused a marked fall (45%) of NOe, with a persistent increase of airway resistance (45%) and lung elastance (12%). Changes in NOe were independent of prostaglandin and TNF-α levels, systemic hypoxia, hypercapnia and acidosis, bronchiolar and alveolar interstitial edema, and pH of exhaled vapor condensate. In contrast, there was a significant relationship between the decrease in NOe and bronchiolar epithelial injury score. This indicates that the fall in NOe, which occurs in the absence of an inflammatory response, is due to the epithelial damage caused by the abnormal stresses related to cyclic opening and closing of small airways with MV on ZEEP, and suggests its use as a sign of peripheral airway injury.

AB - The mechanisms involved in the fall of exhaled nitric oxide (NOe) concentration occurring in normal, anesthetized open chest rabbits with prolonged mechanical ventilation (MV) at low lung volume have been investigated. NOe, pH of exhaled vapor condensate, serum prostaglandin E 2, and F 2α, tumor necrosis factor (TNF-α), PaO 2, PaCO 2, pHa, and lung mechanics were assessed before, during, and after 3-4 h of MV at zero end-expiratory pressure (ZEEP), with fixed tidal volume (9 ml kg -1) and frequency, as well as before and after 3-4 h of MV on PEEP only. Lung histology and wet-to-dry ratio (W/D), and prostaglandin and TNF-α in bronchoalveolar lavage fluid (BALF) were also assessed. While MV on PEEP had no effect on the parameters above, MV on ZEEP caused a marked fall (45%) of NOe, with a persistent increase of airway resistance (45%) and lung elastance (12%). Changes in NOe were independent of prostaglandin and TNF-α levels, systemic hypoxia, hypercapnia and acidosis, bronchiolar and alveolar interstitial edema, and pH of exhaled vapor condensate. In contrast, there was a significant relationship between the decrease in NOe and bronchiolar epithelial injury score. This indicates that the fall in NOe, which occurs in the absence of an inflammatory response, is due to the epithelial damage caused by the abnormal stresses related to cyclic opening and closing of small airways with MV on ZEEP, and suggests its use as a sign of peripheral airway injury.

KW - Low volume ventilation

KW - Lung mechanics

KW - Nitric oxide

KW - Prostaglandins

KW - Small airway injury

UR - http://www.scopus.com/inward/record.url?scp=38649096917&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=38649096917&partnerID=8YFLogxK

U2 - 10.1016/j.resp.2007.10.001

DO - 10.1016/j.resp.2007.10.001

M3 - Article

VL - 160

SP - 215

EP - 223

JO - Respiratory Physiology and Neurobiology

JF - Respiratory Physiology and Neurobiology

SN - 1569-9048

IS - 2

ER -