医学
肺
肺挫伤
支气管肺泡灌洗
病理
麻醉
迟钝的
外科
内科学
作者
Krishnan Raghavendran,Bruce A. Davidson,Jadwiga D. Helinski,Cristi J. Marschke,Patricia A. Manderscheid,James A. Woytash,Robert H. Notter,Paul R. Knight
出处
期刊:Anesthesia & Analgesia
[Ovid Technologies (Wolters Kluwer)]
日期:2005-10-11
卷期号:101 (5): 1482-1489
被引量:111
标识
DOI:10.1213/01.ane.0000180201.25746.1f
摘要
In Brief Lung contusion affects 17%–25% of adult blunt trauma patients, and is the leading cause of death from blunt thoracic injury. A small animal model for isolated bilateral lung contusion has not been developed. We induced lung contusion in anesthetized rats by dropping a 0.3-kg weight onto a precordial protective shield to direct the impact force away from the heart and toward the lungs. Lung injury was characterized as a function of chest impact energy (1.8–2.7 J) by measurements of arterial oxygenation, bronchoalveolar lavage (BAL) albumin and cytology, pressure-volume mechanics, and histopathology. Histology confirmed bilateral lung contusion without substantial cardiac muscle trauma. Rats receiving 2.7 J of chest impact energy had 33% mortality that exceeded prospectively defined limits for sublethal injury. Hypoxemia in rats with maximal sublethal injury (2.45 J) met criteria for acute lung injury at ≤24 h, improving by 48 h. BAL albumin levels were highest at ≤24 h, and remained elevated along with increased BAL leukocytes and decreased lung volumes at 48 h. We concluded that an impact energy of 2.45 J induces isolated, bilateral lung contusion and provides a useful model for future mechanistic pathophysiological assessments. IMPLICATIONS: Lung contusion is a common problem encountered by victims of motor vehicular accidents. We have developed a rat model for lung contusion that does not involve any significant associated injury to the heart. This model will be helpful in ascertaining the complex mechanisms involved in the pathogenesis of lung contusion.
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