学術雑誌論文 What is Happening in The Ards Piglet Lungs: - The Origin of B-Lines on Ultrasonography -

NIshimura, Masayuki  ,  Tsubo, Toshihito  ,  Hirota, Kazuyoshi

68 ( 1 )  , pp.14 - 22 , 2017-10-05 , 弘前大学大学院医学研究科・弘前医学会
ISSN:0439-1721
NII書誌ID(NCID):AN00211444
内容記述
B-lines are the important signs of pulmonary edema in acute respiratory distress syndrome(ARDS) detected with ultrasonography. We studied the mechanism of the origin and disappearance of B-lines inARDS piglets using ultrasonography and microscopy.Methods: ARDS was induced by intratracheal administration of 0.1M Hydrochloric Acid (HCl) in 23 anesthetized,ventilated piglets. The occurrence of B-lines was evaluated using transthoracic echography (TTE) andtransesophageal echography (TEE). Changes in B-lines were recorded after a saline infusion into the pleural space,and after pulmonary consolidation developed and reached the pleura. Left lower lobe was excised and lung sectionswere examined by light microscopy.Results: Following the saline infusion into the pleural space, we observed B-lines fanning out from the visceralpleura. As pulmonary consolidation developed, B-lines disappeared. The structure that B-lines fanned out from wasthe complex of thickened pleura and sub-pleural interlobular septa surrounded by gas. In the tissue where B-linesdisappeared, the thickened sub-pleural interlobular septa were surrounded by cells and liquid.Conclusions: We found that B-lines derive from the complex of thickened pleura and sub-pleural interlobular septasurrounded by gas. B-lines disappeared when the sub-pleural thickened interlobular septa were surrounded by cells and liquid.
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http://repository.ul.hirosaki-u.ac.jp/dspace/bitstream/10129/6144/1/HirosakiMedJ_68%281%29_14.pdf

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