Research output: Contribution to journal › Article › Academic › peer-review
Reducing atelectasis attenuates bacterial growth and translocation in experimental pneumonia. / van Kaam, Anton H.; Lachmann, Robert A.; Herting, Egbert et al.
In: American journal of respiratory and critical care medicine, Vol. 169, No. 9, 2004, p. 1046-1053.Research output: Contribution to journal › Article › Academic › peer-review
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TY - JOUR
T1 - Reducing atelectasis attenuates bacterial growth and translocation in experimental pneumonia
AU - van Kaam, Anton H.
AU - Lachmann, Robert A.
AU - Herting, Egbert
AU - de Jaegere, Anne
AU - van Iwaarden, Freek
AU - Noorduyn, L. Arnold
AU - Kok, Joke H.
AU - Haitsma, Jack J.
AU - Lachmann, Burkhard
PY - 2004
Y1 - 2004
N2 - Besides being one of the mechanisms responsible for ventilator-induced lung injury, atelectasis also seems to aggravate the course of experimental pneumonia. In this study, we examined the effect of reducing the degree of atelectasis by natural modified surfactant and/or open lung ventilation on bacterial growth and translocation in a piglet model of Group B streptococcal pneumonia. After creating surfactant deficiency by whole lung lavage, intratracheal instillation of bacteria induced severe pneumonia with bacterial translocation into the blood stream, resulting in a mortality rate of almost 80%. Treatment with 300 mg/kg of exogenous surfactant before instillation of streptococci attenuated both bacterial growth and translocation and prevented clinical deterioration. This goal was also achieved by reversing atelectasis in lavaged animals via open lung ventilation. Combining both exogenous surfactant and open lung ventilation prevented bacterial translocation completely, comparable to Group B streptococci instillation into healthy animals. We conclude that exogenous surfactant and open lung ventilation attenuate bacterial growth and translocation in experimental pneumonia and that this attenuation is at least in part mediated by a reduction in atelectasis. These findings suggest that minimizing alveolar collapse by exogenous surfactant and open lung ventilation may reduce the risk of pneumonia and subsequent sepsis in ventilated patients
AB - Besides being one of the mechanisms responsible for ventilator-induced lung injury, atelectasis also seems to aggravate the course of experimental pneumonia. In this study, we examined the effect of reducing the degree of atelectasis by natural modified surfactant and/or open lung ventilation on bacterial growth and translocation in a piglet model of Group B streptococcal pneumonia. After creating surfactant deficiency by whole lung lavage, intratracheal instillation of bacteria induced severe pneumonia with bacterial translocation into the blood stream, resulting in a mortality rate of almost 80%. Treatment with 300 mg/kg of exogenous surfactant before instillation of streptococci attenuated both bacterial growth and translocation and prevented clinical deterioration. This goal was also achieved by reversing atelectasis in lavaged animals via open lung ventilation. Combining both exogenous surfactant and open lung ventilation prevented bacterial translocation completely, comparable to Group B streptococci instillation into healthy animals. We conclude that exogenous surfactant and open lung ventilation attenuate bacterial growth and translocation in experimental pneumonia and that this attenuation is at least in part mediated by a reduction in atelectasis. These findings suggest that minimizing alveolar collapse by exogenous surfactant and open lung ventilation may reduce the risk of pneumonia and subsequent sepsis in ventilated patients
U2 - 10.1164/rccm.200312-1779OC
DO - 10.1164/rccm.200312-1779OC
M3 - Article
C2 - 14977624
VL - 169
SP - 1046
EP - 1053
JO - American journal of respiratory and critical care medicine
JF - American journal of respiratory and critical care medicine
SN - 1073-449X
IS - 9
ER -
ID: 697284