Preemptive hemodynamic intervention restricting the administration of fluids attenuates lung edema progression in oleic acid-induced lung injury

Objective: A study is made of the influence of preemptive hemodynamic intervention restricting fluid administration upon the development of oleic acid-induced lung injury. Design: A randomized in vivo study in rabbits was carried out. Setting: University research laboratory. Subjects: Sixteen anesthetized, mechanically ventilated rabbits. Variables: Hemodynamic measurements obtained by transesophageal Doppler signal. Respiratory mechanics computed by a least square fitting method. Lung edema assessed by the ratio of wet weight to dry weight of the right lung. Histological examination of the left lung. Interventions: Animals were randomly assigned to either the early protective lung strategy (EPLS) (n = 8) or the early protective hemodynamic strategy (EPHS) (n= 8). In both groups, lung injury was induced by the intravenous infusion of oleic acid (OA) (0.133 ml kg(-1) h(-1) for 2 h). At the same time, the EPLS group received 15.ml kg(-1) h(-1) of Ringer lactate solution, while the EPHS group received 30 ml kg(-1) h(-1). Measurements were obtained at baseline and 1 and 2 h after starting OA infusion. Results: After 2 h, the cardiac index decreased in the EPLS group (p < 0.05), whereas in the EPHS group it remained unchanged. Lung compliance decreased significantly only in the EPHS group (p < 0.05). Lung edema was greater in the EPHS group (p < 0.05). Histological damage proved similar in both groups (p=0.4). Conclusions: In this experimental model of early lung injury, lung edema progression was attenuated by preemptively restricting the administration of fluids. (C) 2016 Elsevier Espana, S.L.U. y SEMICYUC. All rights reserved.