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Acid aspiration increases sensitivity to increased ambient oxygen concentrations
Departments of 1 Anesthesiology, 2 Microbiology, and 3 Pharmacology, State University of New York at Buffalo, Buffalo 14214; and 4 Department of Pediatrics, University of Rochester, Rochester, New York 14642 Previously we have demonstrated that prolonged exposure to 100% ambient oxygen leads to...
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Published in: | American journal of physiology. Lung cellular and molecular physiology 2000-06, Vol.278 (6), p.1240-L1247 |
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Main Authors: | , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | Departments of 1 Anesthesiology,
2 Microbiology, and
3 Pharmacology, State University of New York
at Buffalo, Buffalo 14214; and 4 Department
of Pediatrics, University of Rochester, Rochester, New York
14642
Previously we
have demonstrated that prolonged exposure to 100% ambient oxygen leads
to a marked loss in functional lung volume and lung compliance,
hypoxemia, and surfactant system abnormalities similar to acute
respiratory distress syndrome (ARDS). However, 50% oxygen
administration is believed to be safe in most clinical settings. In the
present study, we have evaluated the effects of a 24-h exposure to 50%
oxygen in rabbits immediately following experimental gastric acid
aspiration. Mild hypoxemia, but no changes in mortality, lung volume,
lung compliance, surfactant metabolism, or edema formation occurred
after 24 h of normoxia postacid aspiration. Conversely, a relatively
short (24-h) exposure to 50% oxygen after acid aspiration results in
increased pulmonary edema, physical signs of respiratory distress, and
mortality, as well as decreased arterial oxygenation, lung volume, lung
compliance, and type II alveolar cell surfactant synthesis. These
results suggest that acid aspiration alters the "set point" for
oxygen toxicity, possibly by "priming" cells through activation
of inflammatory pathways. This pathogenic mechanism may
contribute to the progression of aspiration pneumonia to ARDS.
aspiration pneumonia; acute respiratory distress syndrome; oxidant
stress |
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ISSN: | 1040-0605 1522-1504 |
DOI: | 10.1152/ajplung.2000.278.6.l1240 |