Hypercapnia via reduced rate and tidal volume contributes to lipopolysaccharide-induced lung injury

JD Lang, M Figueroa, KD Sanders, M Aslan… - American journal of …, 2005 - atsjournals.org
JD Lang, M Figueroa, KD Sanders, M Aslan, Y Liu, P Chumley, BA Freeman
American journal of respiratory and critical care medicine, 2005atsjournals.org
Appreciating that CO2 modifies the chemical reactivity of nitric oxide (NO)–derived
inflammatory oxidants, we investigated whether hypercapnia would modulate pulmonary
inflammatory responses. Rabbits (n= 72) were ventilated with approximately 7-ml/kg tidal
volume for 6 hours. Animals were randomized to one of the following conditions: eucapnia
(PaCO2 at approximately 35–40 mm Hg), eucapnia+ lipopolysaccharide (LPS), eucapnia+
LPS+ inhaled NO (iNO delivered at approximately 20 ppm), hypercapnia (PaCO2 at …
Appreciating that CO2 modifies the chemical reactivity of nitric oxide (NO)–derived inflammatory oxidants, we investigated whether hypercapnia would modulate pulmonary inflammatory responses. Rabbits (n = 72) were ventilated with approximately 7-ml/kg tidal volume for 6 hours. Animals were randomized to one of the following conditions: eucapnia (PaCO2 at approximately 35–40 mm Hg), eucapnia + lipopolysaccharide (LPS), eucapnia + LPS + inhaled NO (iNO delivered at approximately 20 ppm), hypercapnia (PaCO2 at approximately 60 mm Hg), hypercapnia + LPS, and hypercapnia + LPS + iNO. The hypercapnia + LPS groups compared with groups exposed to eucapnia + LPS displayed significantly increased bronchoalveolar lavage fluid protein concentrations (p < 0.05), lung wet-to-dry ratios (p < 0.05), bronchoalveolar lavage fluid cell counts (p < 0.05), and lung histologic alterations consistent with greater injury. Furthermore, expression of inducible nitric oxide synthase (p < 0.05), tissue myeloperoxidase content (p < 0.05), and formation of lung protein 3-nitrotyrosine derivatives (p < 0.05) was greatest under conditions of hypercapnia + LPS. Groups exposed to hypercapnic conditions without LPS did not manifest these changes. The inhalation of iNO attenuated selected indices of lung injury. We conclude that hypercapnia induced by means of reduced rate and tidal volume amplifies pulmonary inflammatory responses.
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