Real-world Ontologies - Ontology Alignment

A normalidade dos dados foi analisada pelo teste de Kolmogorov-Smirnov. Os dados paramétricos foram expressos como média ± erro padrão, enquanto os dados não paramétricos foram expressos como mediana (intervalo interquartil). Os dados paramétricos foram analisados pela análise de variância (ANOVA), seguida pelo

teste de Tukey quando necessário. Os dados não paramétricos foram analisados pelo teste de Kruskal-Wallis, seguido do teste de Mann-Whitney quando necessário. A correção de Bonferroni foi aplicada para as análises repetidas. A diferença foi considerada estatisticamente significante com resultado de o p <0,05. Todas as análises estatísticas foram realizadas utilizando o programa SPSS 17.0 for Windows (SPSS Inc, Illinois, EUA).

7 RESULTADOS E DISCUSS

O

Os resultados e a discussão serão apresentados sob a forma do artigo intitulado

“The effects of prone position ventilation on experimental mild acute lung injury induced by intraperitoneal lipopolysaccharide injection in rats”, (Apêndice A), o qual

7.1 RESUMO DO ARTIGO

The effects of prone position ventilation on experimental mild acute lung injury induced by intraperitoneal lipopolysaccharide injection in rats

Aydra Mendes Almeida Bianchi1,2, Maycon Moura Reboredo1,2, Leda Marília Fonseca Lucinda1,2_{, Fernando Fonseca Reis}1,2_{, Manfrinni Vinícius Alves Silva}1,2_{, Maria}

Aparecida Esteves Rabelo1, Marcelo Alcantara Holanda3, Júlio César Abreu Oliveira1, José Ángel Lorente4, Bruno do Valle Pinheiro*1,2

1. Pulmonary Research Laboratory, Federal University of Juiz de Fora, Av. Eugênio do Nascimento - s/nº, Dom Bosco, Juiz de Fora, Minas Gerais, 36038-330, Brazil 2. Center of Reproductive Biology, Federal University of Juiz de Fora, Rua José Lourenço Khelmer - s/n, Campus Universitário, São Pedro, Juiz de Fora, Minas Gerais, 36036-900, Brazil

3. Laboratory of Respiration, Department of Internal Medicine, Federal University of Ceará, Rua Coronel Nunes de Melo – 1315, Rodolfo Teófilo, Fortaleza, Ceará, 60430-140, Brasil

4. University Hospital of Getafe, Carretera de Toledo A-42, Km 12500, Getafe, Spain

Abstract

Introduction: The benefits of prone position ventilation are well demonstrated in the severe forms of acute respiratory distress syndrome (ARDS), but not in milder forms of this condition. We therefore investigated the effects of the prone position on arterial blood gases, lung inflammation and histology in an experimental mild acute lung injury model.

Methods: Acute lung injury was induced in adult male Wistar rats by intraperitoneal

Escherichia coli lipopolysaccharide injection (5 mg/kg). After 24h, the animals with

PaO2/FIO2 between 200 and 300 mmHg were anesthetized and randomized into 2

groups according to their position during ventilation (prone [n=6] and supine [n=6]). Both groups were compared with a control group (n=5) that received intraperitoneal saline and was ventilated in the supine position. All of the groups were ventilated for 1h with volume-controlled ventilation mode, with tidal volume of 6 ml/kg, respiratory rate of 80 breaths/min, positive end-expiratory pressure of 5 cmH2O, and an inspired

oxygen fraction of 1.

Results: Significantly higher lung injury scores were observed in the LPS-supine group compared to LPS-prone and control groups (0.32 ± 0.03; 0.17 ± 0.03 and 0.13 ± 0.04, respectively) (p<0.001), mainly due to a higher neutrophil infiltration level in the interstitial space and more proteinaceous debris in that filled the airspaces. Similar differences were observed when the gravitational dependent lung regions (dorsal in the supine group and ventral in the prone group – 0.34 ± 0.05 and 0.22 ± 0.04, respectively) (p < 0.05) and non-dependent lung regions (ventral in the supine group and dorsal in the prone group – 0.29 ± 0.04 and 0.13 ± 0.04, respectively) (p < 0.05) were analyzed separately. The BAL neutrophil content was also higher in the LPS-supine group compared to the LPS-prone and control groups. There were no

significant differences in the wet/dry ratio and gas exchange levels among the three groups.

Conclusions: In this experimental extrapulmonary mild acute lung injury model, prone position ventilation for 1 hour, when compared with supine position ventilation, was associated with lower lung inflammation and injury, but without any impact on arterial oxygenation and lung edema.

8 CONSIDERAÇ

ES FINAIS

Neste estudo, avaliamos o efeito da posição prona em um modelo de LPA leve, uma vez que o impacto desta modalidade nas formas mais graves de injúria pulmonar já está bem estabelecido. Nossos resultados apontam para benefícios da ventilação em posição prona, em comparação com a supina, na LPA leve, com redução do número de células inflamatórias no LBA e menor lesão pulmonar à histologia. Nosso estudo não avaliou os eventuais mecanismos responsáveis pela menor inflamação e lesão pulmonar com a posição prona, mas dados da literatura já mostraram que ela protege o pulmão, sobretudo quando já previamente lesado, da LPIV. Esses achados, aliados ao fato de que a posição prona é uma estratégia acessível às unidades de terapia intensiva, desde que com equipe devidamente treinada, reforçam a importância de estudos que elucidem melhor o papel da posição prona na ventilação da LPA em suas formas leves.

9 CONCLUS

O

Neste modelo de LPA leve induzida por LPS intraperitoneal, a posição prona associou-se a menor inflamação e a menor lesão pulmonar, embora sem impacto na troca gasosa e no edema pulmonar.

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APÊNDICE A – Artigo

The effects of prone position ventilation on experimental mild acute lung injury induced by intraperitoneal lipopolysaccharide injection in rats

Aydra Mendes Almeida Bianchi1,2, Maycon Moura Reboredo1,2, Leda Marília Fonseca Lucinda1,2_{, Fernando Fonseca Reis}1,2_{, Manfrinni Vinícius Alves Silva}1,2_{, Maria}

Aparecida Esteves Rabelo1, Marcelo Alcantara Holanda3, Júlio César Abreu Oliveira1, José Ángel Lorente4, Bruno do Valle Pinheiro*1,2

3. Laboratory of Respiration, Department of Internal Medicine, Federal University of Ceará, Rua Coronel Nunes de Melo – 1315, Rodolfo Teófilo, Fortaleza, Ceará, 60430-140, Brasil

4. University Hospital of Getafe, Carretera de Toledo A-42, Km 12500, Getafe, Spain

*Corresponding author

Aydra Mendes Almeida Bianchi: [email protected]

Maycon Moura Reboredo: [email protected] Leda Marília Fonseca Lucinda: [email protected]

Fernando Fonseca Reis: [email protected] Manfrinni Vinícius Alves Silva: [email protected] Maria Aparecida Esteves Rabelo: [email protected] Marcelo Alcantara Holanda: [email protected] Júlio César Abreu Oliveira: [email protected] José Ángel Lorente: [email protected] Bruno do Valle Pinheiro: [email protected]

Abstract

Methods: Acute lung injury was induced in adult male Wistar rats by intraperitoneal

Escherichia coli lipopolysaccharide injection (5 mg/kg). After 24h, the animals with

PaO2/FIO2 between 200 and 300 mmHg were anesthetized and randomized into 2

oxygen fraction of 1.

significant differences in the wet/dry ratio and gas exchange levels among the three groups.

Keywords: acute respiratory distress syndrome, experimental model, prone position, ventilator induced injury.

Introduction

In acute respiratory distress syndrome (ARDS), diffuse alveolo-capillary barrier injury induces inflammatory edema, which increases lung weight. The edematous lung applies a superimposed pressure that collapses the dependent lung regions, which creates a heterogeneous disease [1]. Moreover, the lung bases become compressed by the heart weight and the pressure from the abdominal contents, which increases the atelectasis in the dependent lung regions. Because the dependent regions are more perfused than the non-dependent regions, a large ventilation/perfusion mismatch occurs in ARDS patients, resulting in severe

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