Preventive and therapeutic effects of volume resuscitation with different fluids on acute lung injury induced by LPS and the mechanism

CHEN Na; WANG Shu-ying; PEI Ling

doi:10.3969/j.issn.1002-266X.2015.11.001

Abstract：Objective To investigate the preventive and therapeutic effects of volume resuscitation with different flu -ids on acute lung injury ( ALI) induced by lipopolysaccharide ( LPS) and to discuss the mechanism .Methods Fifty male Sprague-Dawley ( SD) rats were randomly divided into five groups with 10 animals in each group:group A, group B, group C, group D (in those four groups, ALI rats models were induced by intravenous LPS when PaO 2/FiO2≤300), and group E (rats were not induced).Hypertonic sodium chloride hydroxyethyl starch 40 solution, sodium chloride injection and 6%hydroxyethyl starch 130/0.4 solution were infused into rats of group A , group B and group C correspondingly after PaO 2/FiO2≤300mmHg.Group E was infused with the same amount of saline solution .Group D was not injected with any solu-tion.When we started intravenous different fluids , the time was regarded as 0 h.Observing the changes of MAP at pre-in-travenous LPS, 1 h, 3 h and 6 h.At 6 h after volume resuscitation , the blood samples were collected from the femoral ar-tery, and then the serum tumor necrosis factor-α( TNF-α) and surfactant protein-D ( SP-D) concentrations were analyzed by ELISA as well as the blood gas analysis .PaO2 and lactate ( Lac) concentrations were recorded and oxygenation index (PaO2/FiO2) was calculated.After 6 hours, the rats were killed.The lung was removed for determining wet/dry (W/D) weight ratio and for microscopic examination of pathologic changes of lung tissues which were stained by HE staining , and scored according to Mikawa .Results Compared with group E , W/D ratio, serum TNF-α, SP-D, Lac concentrations and pathological scores were increased significantly , MAP, PaO2 and oxygenation index were decreased obviously in groups A , B, C and D.Compared with group D , W/D ratio, serum TNF-a, SP-D, Lac concentrations and pathological scores were decreased significantly , MAP, PaO2 and oxygenation index were increased obviously in groups A , B and C.Compared with group B, W/D ratio, serum TNF-a, SP-D, Lac concentrations and pathological scores were decreased significantly , MAP, PaO2 and oxygenation index were increased obviously in groups A and C .Compared with group C , Lac concentrations were decreased obviously while no significant changes were found in the other parameters in group A ( all P<0 .05 ) .Conclu-sion Three different fluids of volume resuscitation can induce LPS-induced lung injury , and hypertonic sodium chloride hydroxyethyl starch 40 solution presents more effectively than the remaining two and it could be involved in the mechanism of maintaining the mount of SP-D in lung and regulating the anti-inflammation of SP-D and thus reducing the inflammatory response in the lung tissues .