Effect of ventilator-induced lung injury on the development of reperfusion injury in a rat lung transplant model Marc de Perrot, MDa, Yumiko Imai, MDb,

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Effect of ventilator-induced lung injury on the development of reperfusion injury in a rat lung transplant model Marc de Perrot, MDa, Yumiko Imai, MDb, George A. Volgyesi, MDb, Thomas K. Waddell, MDa, Mingyao Liu, MDa, J.Brendan Mullen, MDc, Karen McRae, MDd, Haibo Zhang, MDb, Arthur S. Slutsky, MDb, V.Marco Ranieri, MDe, Shaf Keshavjee, MDa The Journal of Thoracic and Cardiovascular Surgery Volume 124, Issue 6, Pages 1137-1144 (December 2002) DOI: 10.1067/mtc.2002.125056 Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 1 There were marked differences in PEEP and Pplat between the conventional mechanical ventilation group (conventional) and the minimal mechanical stress ventilation group (stress index). The Journal of Thoracic and Cardiovascular Surgery 2002 124, 1137-1144DOI: (10.1067/mtc.2002.125056) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 2 Elastance, which directly correlates with the degree of lung injury, was significantly higher in the conventional mechanical ventilation group (conventional) than in the minimal mechanical stress ventilation group (stress index; ***P <.0001 vs the conventional mechanical ventilation group). The Journal of Thoracic and Cardiovascular Surgery 2002 124, 1137-1144DOI: (10.1067/mtc.2002.125056) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 3 Pao2 of the transplanted lung was significantly higher in the minimal mechanical stress ventilation group (stress index) than in the conventional mechanical ventilation group (conventional; ***P <.0006 vs the conventional mechanical ventilation group). The difference between the Paco2 was not significantly different between groups (P =.1). The Journal of Thoracic and Cardiovascular Surgery 2002 124, 1137-1144DOI: (10.1067/mtc.2002.125056) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 4 The proinflammatory cytokines IL-6 and MIP-2 were significantly lower in the minimal mechanical stress ventilation group (stress index) than in the conventional mechanical ventilation group (conventional; *P <.05 and **P <.01 vs the conventional mechanical ventilation group). TNF-α was not significantly different between groups (P =.1). The Journal of Thoracic and Cardiovascular Surgery 2002 124, 1137-1144DOI: (10.1067/mtc.2002.125056) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 5 Hematoxylin-and-eosin staining showing the formation of hyaline membranes in the conventional mechanical ventilation group and its absence in the minimal mechanical stress ventilation group. The Journal of Thoracic and Cardiovascular Surgery 2002 124, 1137-1144DOI: (10.1067/mtc.2002.125056) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions