Volume 11 Supplement 3

Fourth International Symposium on Intensive Care and Emergency Medicine for Latin America

Open Access

Experimental pulmonary microembolism: effects on hemodynamics, lung mechanics and histopathology

  • LCP Azevedo1,
  • DT Dolci1,
  • CB Fuentes1,
  • M Park1 and
  • GPP Schettino1
Critical Care200711(Suppl 3):P5

https://doi.org/10.1186/cc5792

Published: 19 June 2007

Objectives

To characterize an experimental model of pulmonary embolism by studying hemodynamics, lung mechanics and histopathologic derangements caused by pulmonary microembolism in pigs. To identify lung alterations after embolism that may be similar to those evidenced in pulmonary inflammatory conditions.

Materials and methods

Ten Large White pigs (weight 35–42 kg) were instrumented with arterial and pulmonary catheters, and pulmonary embolism was induced in five pigs by injection of polystyrene microspheres (diameter ~300 μM), in order to obtain a pulmonary mean arterial pressure of twice the baseline value. Five other animals injected with saline served as controls. Hemodynamic and respiratory data were collected and pressure × volume curves of the respiratory system were performed by a quasistatic low flow method. Animals were followed for 12 hours, and after death lung fragments were dissected and sent to pathology.

Results

Pulmonary embolism induced a significant reduction in stroke volume (71 ± 18 ml/min/bpm pre vs 36 ± 9 ml/min/bpm post, P < 0.05), an increase in pulmonary mean arterial pressure (27 ± 4 mmHg pre vs 39 ± 6 mmHg post, P < 0.05) and pulmonary vascular resistance (193 ± 122 mmHg/l/min pre vs 451 ± 149 mmHg/l/min post, P < 0.05). Respiratory dysfunction was evidenced by significant reductions in the PaO2/FiO2 ratio (480 ± 50 pre vs 159 ± 55 post, P < 0.05), the dynamic lung compliance (27 ± 6 ml/cmH2O pre vs 19 ± 5 ml/cmH2O post, P < 0.05), the increase in dead space ventilation (20 ± 4 pre vs 47 ± 20 post, P < 0.05) and, the shift of pressure × volume curves to the right, with reduction in pulmonary hysteresis. Pathology depicted inflammatory neutrophil infiltrates, alveolar edema, collapse and hemorrhagic infarctions.

Conclusion

This model of embolism is associated with cardiovascular dysfunction, as well as respiratory injury characterized by a decrease in oxygenation, lung compliance and hysteresis. Pathology findings were similar to those verified in inflammatory pulmonary injury conditions. This model may be useful to study pathophysiology, as well as pharmacologic and ventilatory interventions useful to treat pulmonary embolism.

Authors’ Affiliations

(1)
Intensive Care and Anesthesiology Research Laboratory, Research and Education Institute, Hospital Sírio-Libanês

Copyright

© BioMed Central Ltd 2007

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