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A porcine model of acute lung injury by instillation of gastric fluid.

Authors :: Meers CM
De Wever W
Verbeken E
Mertens V
Wauters S
De Vleeschauwer SI
Vos R
Vanaudenaerde BM
Verleden GM
Van Raemdonck DE
Source :: The Journal of surgical research [J Surg Res] 2011 Apr; Vol. 166 (2), pp. e195-204. Date of Electronic Publication: 2010 Nov 13.
Publication Year :: 2011
Abstract: Background: About 15% of donor lungs are declined because of aspiration contributing to current organ shortage. The aim was to develop a porcine lung injury model by gastric juice (GJ) instillation to study different pretransplant treatment strategies.<br />Materials and Methods: Pigs (n = 6/group) were anesthetized and monitored. At T0 bronchoalveolar lavage (BAL) was performed followed by instillation of 4 mL/kg GJ or saline solution (SAL). Hemodynamics, aerodynamics and oxygenation were recorded for two hours. Serum samples were collected. At T120 a second BAL was performed. CT scans of explanted, inflated lungs were taken, tissue samples were collected and wet/dry weight ratio (W/D) was calculated. Pepsin and bile acids were measured in BAL. IL-8, CRP and MMP-9 were measured in serum and in BAL.<br />Result: Oxygenation and lung compliance was lower in [GJ] versus [SAL] (P < 0.01 and P < 0.001, respectively). More consolidation areas were noticed on CT in GJ versus SAL (P < 0.01). Hemorrhage, edema and neutrophil inflammation were seen on histology in [GJ] (P < 0.01, P < 0.001, P < 0.001, respectively). BAL neutrophils, pepsin, bile acids, and IL-8 (P < 0.05) increased in [GJ]. W/D was higher in [GJ] versus SAL (P < 0.001).<br />Conclusion: Instillation of GJ in pig lungs caused acute lung injury with impaired oxygenation and increased inflammation in BAL, on histology, and on imaging. This model holds promise to assess the efficacy of a broad range of treatment strategies including ex vivo lung perfusion (EVLP).<br /> (Copyright © 2011 Elsevier Inc. All rights reserved.)