Çiğdem YARDIMCI, Meyancı Güniz KÖKSAL, Işıl PAKİŞ, DİLDAR KONUKOĞLU, HÜSEYİN ÖZ

Tavşanlarda düşük tidal volümlerle uygulanan PEEP ve Sigh 'ın sağlıklı akciğerdeki etkileri

Çalışmamızda, düşük tidal volümlerle mekanik ventilasyon uygulaması sırasında alveollerde stabilizasyonu sağlamak için kullanılan sigh ve PEEP'in sağlıklı akciğer dokusu üzerindeki histopatolojik değişikliklere ve lipit peroksidasyonuna etkilerini karşılaştırmayı amaçladık. Onaltı Yeni Zelanda tavşanı çalışmaya dahil edildi. Tüm tavşanlara ketamin sedasyonu ile trakeostomi açıldı. V auricularis caudalise intravenöz kanül yerleştirilerek sıvı ve anestezi idamesi sağlandı. Plazma malonildialdehit (MDA) tayini için kan örnekleri alındıktan sonra tavşanlar rastgele 2 gruba ayrıldılar (n:8). Birinci grup, 5 ml $kg^-1$ tidal volüm ve sigh (100 solunumda 2 kez tidal volümünün 1.5 katı), ikinci grup ise düşük tidal (5 ml $kg^-1$) volüm ve 10 cm H2O PEEP ile 3 saat ventile edildi. Üçüncü saatin sonunda MDA için kan örnekleri alındıktan sonra tavşanlar sakrifiye edildi. Akciğerler histopatolojik olarak incelenmek üzere çıkarıldı. Işık mikroskobunda incelenen doku örnekleri 0/4 arasında skorlandı. Verilerin karşılaştırılmasında Mann Whitney U testi kullanıldı. Grupların ortalama plazma MDA düzeyleri karşılaştırıldığında, 3. saatin sonunda sigh grubunun MDA düzeyi PEEP grubundan yüksek bulundu (p

Anahtar Kelimeler:

Pozitif-basınçlı solunum, Akciğer, Tidal volüm, Lipid peroksidasyonu, Malondialdehit

The effects of low tidal volume applied with PEEP and Sigh on healthy lung in rabbits

In our study we aimed to compare the effects of sigh and PEEP used f or stabilization of alveoli during mechanical ventilation with low tidal volumes on histopathological structure and lipid peroxidation in healthy lung tissues. In this study, 16 healthy New Zealand albino rabbits were anaesthetized with ketamine. Tracheostomy was performed in all rabbits and ketamine was infused for maintenance via v. auricularis caudalis. The rabbits were randomly divided into two gro-ups (n=8). Group I received low tidal volume and (5 mL $kg^-1$ ) and sigh (twice in every 100 breaths, 1.5 times of the tidal volu-me) for three hours. Group II received low tidal volume (5 mL $kg^-1$ ) and 10 cm H2O PEEP for three hours. Plasma MDA malondialdehyde levels were performed at the beginning of the study and at the end of third hour. The rabbits were sacnfied at the end of the study. Lungs were then excised and kept with 10 % formaldehit solution, and were stained with Haemotoxilyn-Eosine dye. Lungs were then evaluated for histopathological assessment under light microscopy and were scored between 0-4. The findings were analysed with Mann Whitney-U test. There was a significant increase in plasma MDA values in Group I as compared with Group II at the end of the third hour (p<0.05). Neutrophil infiltration and atelectatic areas were more severe in Group I than Group II (p<0.05). In conclusion, PEEP caused less histopathological changes and lipid peroxidation when was compared with sigh for alveolar stabilization.

Keywords:

Positive-Pressure Respiration, Lung, Tidal Volume, Lipid Peroxidation, Malondialdehyde,

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