Lung and Diaphragm Damage at Varying Oxygen Levels and Ventilator Modes Pst Hemorrhagic
Final rept. 1 Apr 2008-30 Sep 2011
KANSAS UNIV MEDICAL CENTER KANSAS CITY
Pagination or Media Count:
Purpose To determine 1 lung and diaphragm damage at various fractions of inspired oxygen FIO2 with and without dopamine following hemorrhagic shock HS, and 2 the extent of lung damage produced by administering three controlled mechanical ventilator modes following HS. Design A quasi-experimental design using an in vivo animal model. Methods Forty percent of the total blood volume was removed from anesthetized rats to elicit HS. Hydrogen peroxide H2O2 and apoptosis were measured in the lung and diaphragm after 60 minutes of administration with the following FIO2s 0.21, 0.40, 0.60, 1.00, and with the addition of dopamine 10 microngkgmin. In another set of experiments, volume control VC, pressure control PC, and pressure-regulated volume control PRVC MV were administered post HS and lung H2O2 and apoptosis were measured. Sample A total of 180 rats were used in experimental protocols. Analysis Differences in lung and diaphragm H2O2 and apoptosis were analyzed using analysis of variance ANOVA and followed by post hoc tests. Significance was defined as P 0.05. Findings The optimal FIO2 to utilize following hemorrhagic shock was 0.40. Dopamine administered intravenously 10 micro gkgmin scavenged reactive oxygen species ROS, thus reducing lung and diaphragm damage when higher concentrations of O2 were used. During HS, the ideal mode of controlled MV was PRVC. MitoSox Red was a potential biomarker for superoxide. Implications for Military Nursing To reduce organ damage following HS, military nurses need to use the optimal O2 40 to prevent excess oxygen molecules to become dangerous free radicals. Dopamine should be administered if higher concentration of O2 is required. If controlled MV is necessary, a mixed mode of MV such as PRVC should be applied. In addition, using a biomarker such as MitoSox Red would be useful in monitoring the amount of oxidative stress in HS patients.
- Anatomy and Physiology
- Medicine and Medical Research