Tavşanlarda asit aspirasyonu ile oluşturulan akut akciğer hasarında spironolakton ve sürfaktan tedavisinin histopatolojik incelenmesi ve HMGB1, CRP, IL1-ß ve TNF-a üzerine etkisi

MUHAMMET EMİN NALDAN

Tavşanlarda asit aspirasyonu ile oluşturulan akut akciğer hasarında spironolakton ve sürfaktan tedavisinin histopatolojik incelenmesi ve HMGB1, CRP, IL1-ß ve TNF-a üzerine etkisi

Thesis Type: Expertise In Medicine

Institution Of The Thesis: Ataturk University, Tıp Fakültesi, Cerrahi Tıp Bilimleri, Turkey

Approval Date: 2012

Thesis Language: Turkish

Student: MUHAMMET EMİN NALDAN

Supervisor: Canan Atalay

Open Archive Collection: AVESIS Open Access Collection

Abstract:

Histopathological evaluation of sprinolacton and surfactant treatment in rabbits with acute pulmonary injury caused by acid aspiration and the effects of the treatment on HMGB1, CRP, lL1-ß ve TNF-? levels.ARDS (acute respiratory distress syndrome) is the dysfunction of the pulmonary capillary endothelium and alveolar epithelium.In this study we have investigated the efficiency of intragasrtic sprinolacton and intrathecal surfactant treatment evulating and comparing the blood levels of HMGB1 (high-mobility group box-1), IL1ß (interlökin-1 beta), TNF? (tumor necrosis factor alfa), and CRP (C-reactive protein) which are acute phase reactants in experimental acute pulmonary injury model.This study included 40 New zeland rabbits which were randomly divided into five groups (Group C control group, Group T tracheostomy group, Group A: ARDS group, Group S1 sprinolacton group, group S2 surfactant group). Subjects have been fasted for 8 hour befıre the experiment and have been anesthetised with 50mg/kg sodium penthal.Only blood samples are taken from group K.Blood samples are taken from group T after exposure of the femoral arteries at 6th and 24 th hours.Tracheostomy is performed on group a and 0.4 mL/kg 0.1 mol/L of HCl(Hydrochloric acid) (pH ~ 1.25) is given intratheccally through the endotracheal cannule in order to cause pulmonary injury and volüme controlled mechanic ventilation is performed.Tracheostomy is performed on group S1 and spironolacton is given through nasogastric tube (100 mg/kg) 30 minutes after the pulmonary injury.Tracheostomy is performed on group S2 and 100mg/kg surfactant is given intratracheally 30 minutes after the pulmonary injury.Tidal volume of the mechanical ventilation was 8 mL/kg and respiratory frequency was 40/min. At the end of the experiment all of the subjects were sacrified by intraperitoneal injection of sodium penthotal and lungs are excised for pathological evulation.Difference between the groups were anaylsed using Kruskal-Wallis test. Comparison of the foups were done by using the Mann-Whitney U test.Group A had statistically significantly lower PO2/FİO2, pO2, SpO2, pH values (p 0,05).In conclusion this study showed that intratracheal surfactant and intragastric sprinolacton improved the arterial blood gas values and decreased the blood levels of acute phase reactants which increase in the presence of inflammation and provided histopathologic recovery of the lung in experimental lung injury model.Key Words: Acid aspiration, ALI, ARDS, Spironolactone, Surfactan, HMGB1, CRP, IL1ß ve TNF?.