Acute respiratory distress syndrome (ARDS) is severe medicalcondition
occurring in critically ill patients and with mortality of 33-52 % is one of the leading causes of death in critically ill patients. To better understand pathophysiology of ARDS and to verify novel therapeutical approaches a reliable animal model is needed. Therefore we have developed modified
lavage model of ARDS in the pig. After premedication (ketamine and midazolam)35 healthy pigs were anesthetized (propofol, midazolam,
morphin, pipecuronium) and orotracheally intubated and ventilated. Primary
ARDS was induced by repeated cycles of lunglavage with a detergent Triton X100 diluted in saline (0.03 %) heated to 37 °C preceded by pre
-oxygenation with 100 % O2. Single cycle included two subsequent lavages
followed by detergent suction. Eachcyclewas followed by hemodynamic
andventilation stabilization for approx. 15 min, with eventualadministration of vasopressors according to an arterial bloodpressure. The lavage procedure
was repeated until the paO2/FiO2index after stabilization remained below 100 at PEEP 5 cm H2O. In 33 pigs we have achieved the desired degree
of severe ARDS(PaO2/FiO2<100). Typical number of lavages was 2-3 (min. 1,max.5). Hemodynamictolerance and the need for vasopressors
were strongly individual. In remainingtwo animalsan unmanageable hypotension developed. For other subjects theexperimental ARDS stability was good and allowed reliablemeasurement for more than 10 h. The
present model of theARDS is clinically relevant and thus it is suitable for further research of the pathophysiology and management of this serious
medical condition.
As with other organ transplants even lung transplantation raises
the question of the possibility of the influence of gender on ischemia
-reperfusion injury. This is a current topic especially for increasingly utilized method of lung transplantation from non-heart-beating donors, where reperfusion preceded by a period of warm and cold ischemia with subsequent treatment options for lung graft reperfusion. For measurements we used our laboratory previously created and validated animal model for ex vivo lung transplantation. As with other organ systems of our monitoring resulted protective effect of female sex on ischemia reperfusion lung injury. In two of the three parameters that were monitored, we found a significant difference. In females, higher oxygen transfer ability after reperfusion was manifested as well as lower
perfusion pressure (vascular compliance). Conversely, weight gain (the development of pulmonary edema) in males was not significant difference from the females. These conclusions could cause further studies leading to influence the selection of appropriate donor grafts.