The Effects Of Artificial Hydrothorax On Lung Under General Anesthesia In Aid Of High Intensity Focusing Ultrasound Irradiated Goats Liver

Objective To investigate the changes of arterial blood gas, plasmas and BALF content of inflammatory cytokine and lung inflammatory reaction,and to explore its possible mechanisms via the artificial hydrothorax under general anesthesia in aid of high intensity focusing ultrasound irradiated goats liver.Methods Twenty-five male Nan-Jiang yellow goats weighing 14.5～24kg were randomly divided into five groups(n=5 each):control group(group C);general anesthesia(group A);general anesthesia and artificial hydrothorax(group B);general anesthesia and HIFU(group H); general anesthesia,artificial hydrothorax and HIFU(group D).After general anesthesia,artificial right hydrothorax was created by instilling 10ml/kg normal saline at the right anterior axillary line of the fourth to sixth intercostals space in group B and D.The livers in the hepatic diaphragmatic dome were irradiated by HIFU in group H and group D.The pressures of airway were monitored and recorded,before created artificial hydrothorax(T₀),at the moment of created artificial hydrothorax(T₁),at the moment of HIFU irradiated after artificial hydrothorax built 30min(T₂),1, 2 hours after artificial hydrothorax built(T₃,T₄)and at the end of the experiment(T₅).Arterial blood gas was monitored and vein blood samples were obtained at different stage of experiment:before created artificial hydrothorax(at the moment of tracheal intubation)(T_a),after created artificial hydrothorax 2 hours later(T_b),and at the end of the experiment(T_c). The animals were killed at the end of 4h experiment,the lung was immediately removed for bronchoalvelolar lavaged and collected BALF and determination of MDA content,MPO and GSH-PX and LDH activities, determination weight of wet/dry ratio of lung,a sandwich ELISA was used to determine plasmas and bronchoalveloar lavage fluid interleukin-6 and TNF-αcontent,and light microscope examination for the degree of lung damage of pathology.Results Except group C,at T₁～T₅,the pressure of airway was higher in group B and group D than in group A and group H(P＜0.05).The pressure of airway was higher in group B and group D at T₁～T₅ than T₀(P＜0.05).At T_a,the PH and PO₂ in arterial blood were lower and the PCO₂ was higher in group A,H,B and D than in control group(P＜0.05). But there were no obviously differences in PH,PO₂ and PCO₂ almong all groups at T_b～T_c(P＞0.05);the PH and PO₂ of arterial blood were higher and the PCO₂ was lower in group A,H,B and group D at T_b～T_c than T_a (P＜0.05).The MPO and LDH activity,MDA content and Wet/Dry ratio of lung weight ratio were higher and the GSH-PX activity was lower in the lung tissue in group B and group D than in control group,group A and group H(P＜0.05),there were no significant differences in these variables between group B and D(P＞0.05).The content of bronchoalveloar lavage fluid interleukin-6,TNF-αand protein were higher in group B and group D than in control group,group A and group H(P＜0.05).In group comparison, at T_b,the content of blood plasma interleukin-6 and TNF-αwere higher in group B,D and group H than in group A and group C(P＜0.05),the content of blood plasma interleukin-6 and TNF-αwere higher in group B,D and H than group A and C,in group H than group B,in group D than group B and H at T_c(P＜0.05).The content of blood plasma interleukin-6 and TNF-αwas higher in group B,H and D at T_b～T_c than T_a,T_c than T_a～b(P＜0.05).In group B and D,the lung tissues were obviously congested,the lung tissues and alveolar space were infiltrated by a large number of inflammatory cells and neutrophils.Conclusion Artificial hydrothorax in aid of HIFU irradiated goats liver in vivo could cause some injury to lung.With the extension of time, artificial hydrothorax induced more serious lung injury,there was no effective injury to lung by anesthesia and by HIFU under general anesthesia.Artificial hydrothorax under general anaesthesia hadn't distinct influence on the venting and diffusion function of lungs,though artificial hydrothorax itself caused some injury to lungs,which shows that it is safe for artificial hydrothorax on lung under general anesthesia in aid of high intensity focusing ultrasound irradiated goats liver.