Changes in inspiratory effort in severe hypoxia against the backdrop of interleukin-6 and tumor necrosis factor
DOI:
https://doi.org/10.33910/2687-1270-2022-3-3-359-366Keywords:
proinflammatory cytokines, acute respiratory distress syndrome, hypoxia, inspiratory effort, intra-thoracic pressure, breathing patternAbstract
Today, it is paramount to clarify the role of proinflammatory cytokines in the acute respiratory distress syndrome (ARDS) with severe hypoxemia and systemic inflammatory reaction (SIR). Previously, we found that an increase in the number of circulating IL-1ß and TNF-α suppressing the compensatory reaction of pulmonary ventilation to hypoxia is the main cause of respiratory failure and reduced survival after hypoxic apnea. IL-6 does not cause respiratory decompensation in severe hypoxia, instead, it increases the risk of mortality compared to IL-1ß and TNF-α. We suggested that this difference in the nature of respiratory reactions may be due to the opposite biological effects that cytokines have on the generation of inspiratory effort which is indicative of the activity of respiratory muscles. We conducted a comparative assessment of the effect of intravenous administration of IL-6 and TNF-α on the generation of inspiratory effort (intra-thoracic pressure) and the breathing pattern in hypoxia. In anesthetized rats hypoxia was reproduced by the rebreathing method from normoxia up to apnea. The data were analyzed at FIO2 8%. The recorded parameters include respiratory volume (Vt), breathing frequency (BF), minute lung ventilation (MLV), esophageal pressure (Pes), and survival after hypoxic apnea. It was found that in severe hypoxia IL-6 does not suppress the generation of inspiratory effort and the activity of the respiratory muscles, hence, it does not lead to decompensation of the respiratory function. TNF-α contributes to the development of acute respiratory failure due to the weakening of the inspiratory effort and its contribution to the formation of the breathing pattern.
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