Open Access Research

High frequency oscillatory ventilation attenuates the activation of alveolar macrophages and neutrophils in lung injury

Motomu Shimaoku1, Yuji Fujino1, Nobuyuki Taenaka1, Takachika Hiroi2, Hiroshi Kiyono2 and Ikuto Yoshiya1

Author Affiliations

1 Intensive Care Unit, Osaka University Hospital, Osaka University, Yamadaoka, Suita, Osaka 565, Japan

2 Research Institute for Microbial Diseases, Osaka University, Yamadaoka, Suita, Osaka 565, Japan

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Critical Care 1998, 2:35-39 doi:10.1186/cc122

Published: 12 March 1998

Abstract

Background

Recent investigations have shown that leukocyte activation is involved in the pathogenesis of ventilator-associated lung injury. This study was designed to investigate whether the inflammatory responses and deterioration of oxygenation in ventilator-associated lung injury are attenuated by high-frequency oscillatory ventilation (HFO). We analyzed the effects of HFO compared with conventional mechanical ventilation (CMV) on the activation of pulmonary macrophages and neutrophils in 10 female rabbits.

Results

After surfactant depletion, the rabbits were ventilated by CMV or HFO at the same mean airway pressure. Surfactant-depletion followed by 4 h mechanical ventilation hindered pulmonary oxygenation in both groups. Impairment of oxygenation was less severe in the HFO group than in the CMV group. In the HFO group the infiltration of granulocytes into alveolar spaces occurred more readily than in the CMV group. Compared with CMV, HFO resulted in greater attenuation of β2-integrin expression, not only on granulocytes, but also on macrophages.

Conclusions

In the surfactant-depleted lung, the activation of leukocytes was attenuated by HFO. Reduced inflammatory response correlated with decreased impairment of oxygenation. HFO may reduce lung injury via the attenuation of pulmonary inflammation.

Keywords:
adhesion molecule; high frequency oscillatory ventilation; leukocyte; lung injury; mechanical ventilation