Prone position prevents regional alveolar hyperinflation and mechanical stress and strain in mild experimental acute lung injury

Maria Cristina E. Santana, Cristiane S.N.B. Garcia, Débora G. Xisto, Lilian K.S. Nagato, Roberta M. Lassance, Luiz Felipe M. Prota, Felipe M. Ornellas, Vera L. Capelozzi, Marcelo M. Morales, Walter A. Zin, Paolo Pelosi, Patricia R.M. Rocco

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

Prone position may delay the development of ventilator-induced lung injury (VILI), but the mechanisms require better elucidation. In experimental mild acute lung injury (ALI), arterial oxygen partial pressure (P aO2), lung mechanics and histology, inflammatory markers [interleukin (IL)-6 and IL-1β], and type III procollagen (PCIII) mRNA expressions were analysed in supine and prone position. Wistar rats were randomly divided into two groups. In controls, saline was intraperitoneally injected while ALI was induced by paraquat. After 24-h, the animals were mechanically ventilated for 1-h in supine or prone positions. In ALI, prone position led to a better blood flow/tissue ratio both in ventral and dorsal regions and was associated with a more homogeneous distribution of alveolar aeration/tissue ratio reducing lung static elastance and viscoelastic pressure, and increasing end-expiratory lung volume and P aO2. PCIII expression was higher in the ventral than dorsal region in supine position, with no regional changes in inflammatory markers. In conclusion, prone position may protect the lungs against VILI, thus reducing pulmonary stress and strain.

Original languageEnglish (US)
Pages (from-to)181-188
Number of pages8
JournalRespiratory Physiology and Neurobiology
Volume167
Issue number2
DOIs
StatePublished - Jun 30 2009
Externally publishedYes

Keywords

  • Gas-exchange
  • Lung histopathology
  • Lung mechanics
  • Tissue stress and strain
  • Ventilator-induced lung injury

ASJC Scopus subject areas

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

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  • Cite this

    Santana, M. C. E., Garcia, C. S. N. B., Xisto, D. G., Nagato, L. K. S., Lassance, R. M., Prota, L. F. M., Ornellas, F. M., Capelozzi, V. L., Morales, M. M., Zin, W. A., Pelosi, P., & Rocco, P. R. M. (2009). Prone position prevents regional alveolar hyperinflation and mechanical stress and strain in mild experimental acute lung injury. Respiratory Physiology and Neurobiology, 167(2), 181-188. https://doi.org/10.1016/j.resp.2009.04.006