Adenosine triphosphate is released during injurious mechanical ventilation and contributes to lung edema

Preston B. Rich, Christelle D. Douillet, Simon A. Mahler, Syed Adil Husain, Richard C. Boucher

Research output: Contribution to journalArticle

49 Scopus citations

Abstract

Background Extracellular nucleotides mediate many cellular functions and are released in response to mechanical stress in vitro. It is unknown whether adenosine triphosphate (ATP) is released in vivo during mechanical ventilation (MV). We hypothesized that stress from high-pressure MV would increase airway ATP, contributing to MV-associated lung edema.Methods Rats were randomized to nonventilated control (n = 6) or 30 minutes of MV with low (15 cm H20, n = 7) or high (40 cm H20, n = 6) pressure. Additional groups received intratracheal ATP (n = 7) or saline (n = 7) before low-pressure MV.Results Low-pressure MV did not affect lung edema or bronchoalveolar lavage (BAL) ATP levels. In contrast, high-pressure MV significantly increased BAL ATP and produced alveolar edema; lactate dehydrogenase was unchanged. Intratracheal ATP administration significantly increased lung water during low-pressure MV.Conclusion High-pressure MV increases BAL ATP concentration without altering lactate dehydrogenase, suggesting that release is not from cell lysis. Intratracheal ATP increases lung water, implicating nucleotides in MV-associated lung edema.

Original languageEnglish (US)
Pages (from-to)290-297
Number of pages8
JournalJournal of Trauma
Volume55
Issue number2
DOIs
StatePublished - Aug 2003

Keywords

  • Adenosine triphosphate
  • Mechanical ventilation
  • Nucleotides
  • PY receptor
  • Pulmonary edema
  • Ventilator-induced lung injury

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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