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Annals of Clinical & Laboratory Science 36:345-352 (2006)
© 2006 Association of Clinical Scientists

Experimentally-Induced Acute Lung Injury: the Protective Effect of Hydroxyethyl Starch

Alessandro Di Filippo1, Marco Ciapetti1, Dolores Prencipe1, Laura Tini1, Andrea Casucci2, Riccardo Ciuti3, Daniela Messeri4, Stefano Falchi5 and Carlo Dani1
1 Department of Critical Care, University of Florence; 2 Department of Oto-Neuro-Ophthalmological Surgical Sciences, University of Florence; 3 Laboratory of Pharmacotoxicology, Careggi University Hospital of Florence; 4 Unit of Infectious Disease, 3rd Local Health Service, Pistoia; and 5 A.S.F. Firenze, IOT Day Surgery, Florence; Italy

Address correspondence to Alessandro Di Filippo M.D., Department of Critical Care, University of Florence, c/o A.U.O.C. Careggi, Viale Morgagni 85, Firenze 50124, Italy; tel 39 055 427 7498; fax 39 055 430 393; e-mail aledanibatibeba{at}hotmail.com.

The objective of this study was to evaluate the effects of hydroxyethyl starch, (130/0.4) 6%, compared to Ringer’s acetate and modified gelatin on hypoxemia, inflammatory response, and oxidative stress in an experimental model of acute lung injury (ALI). The ALI/Adult Respiratory Distress Syndrome (ARDS) experimental model was produced by a bronchoalveolar saline lavage. Mature New Zealand white rabbits were anesthetized, provided with a tracheostomy and vascular catheters, and randomized to receive 25 ml/kg/hr of Ringer’s acetate (group R, n = 7), 25 ml/kg/hr of modified gelatin (group G, n = 7), or 25 ml/kg/hr of hydroxyethyl starch (group S, n = 7). All of the rabbits received mechanical ventilation to maintain the PaCO2 between 35 and 45 mm Hg. Blood gas levels and hemodynamic values were recorded before induction of lung injury (T0) and 10 (T10), 120 (T120) and 240 (T240) min following induction of lung injury. At the same time-points, blood samples were collected to measure the plasma levels of TNF{alpha} (tumor necrosis factor-alpha) and TBARS (thiobarbituric acid-reactive substances). The experiment yielded the following results: The blood PaO2/FiO2 ratio was higher in group S than in groups R and G at T10, T120, and T240 (p <0.05). In group S, the plasma TNF{alpha} and TBARS concentrations were lower than in groups R and G at T120 and T240 (p <0.05). In conclusion, rabbits treated with hydroxyethyl starch, (130/0.4) 6%, demonstrated reductions of hypoxemia, inflammatory response, and oxidative lung damage, compared to raabbits treated with Ringer’s acetate or modified gelatin.

Keywords: acute lung injury, respiratory failure, inflammation, lung disease, broncoalveolar lavage, hydroxyethyl starch






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