Physiological and pathological effects of body position changes on experimental acute lung injury in rabbits

AIM: To study the effects of body position on the physiological and pathological changes in an oleic acid-induced acute lung injury (ALI) model. METHODS: One control group and three experimental groups were set up in which the rabbits were put on supine, prone and rotation, respectively. The changes of blood pressure, heart rate and partial pressure of arterial oxygen, lung mechanics, cytokines in the course of experiment and pathologic changes were observed. RESULTS: At the end of experiment, heart rate in rotated rabbits was lower than that in prone rabbits ［(176.13±26.55) beats/min vs (217.75±14.44) beats/min, P<0.05］. Partial pressure of arterial oxygen and lung compliance in prone and rotated rabbits were higher than that in supine rabbits ［(157.75±51.19) mmHg and (166.08±37.07) mmHg vs (86.59±23.82) mmHg, (2.75±0.89) mL/cmH2O and (2.63±0.74) mL/cmH2O vs (1.63±0.52) mL/cmH2O, respectively, P<0.05］, but intrapulmonary shunt was just up side down. Airway peak inspiration pressure in rotated rabbits was higher than that in prone group rabbits, ［(19.63±2.45) cmH2O vs (16.00±2.27) cmH2O, P<0.05］. TNF-α in supine and rotated rabbits was higher than that in control rabbits, ［(3.12±0.83 and 2.59±0.79) μg/L vs (1.36±0.34) μg/L］, but it was not the case in prone rabbits. Partial pressure of arterial oxygen was positive correlation to lung compliance and negative correlation to intrapulmonary shunt. Dorsal lung edema was more severe than ventral in group 2, ventral lung edema was more severe than dorsal in group 3 and lung edema was diffused in group 4. CONCLUSIONS: Prone and rotation positions increased lung compliance and decreased intrapulmonary shunt accompanied with oxygenation improvement in ALI model, but prone was safer than rotation position, the former can inhibit the secretion of TNF-α. The distribution of lung edema changed with body position changes.