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April 2022
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Eucalyptol inhaled during Invasive Mechanical Ventilation may attenuate Lung Injury caused by oxygen therapy in the management of COVID-19
Daniel Silveira Serra, Leidianne Costa da Silva Andrade, Marcelle Ferreira Moura, Soujanya Talapala Naidu, Allison Matias de Sousa, Fladimir de Lima Gondim, Francisco Sales Ávila Cavalcante
ABSTRACT: INTRODUCTION: Patients who develop Severe Acute Respiratory Syndrome caused by Coronavirus-2 (SARS-CoV-2) may be admitted to an Intensive Care Unit (ICU) and be subjected to prolonged Invasive Mechanical Ventilation (IMV) to receive adequate oxygen therapy. However, IMV associated with high concentrations of oxygen may lead to Hyperoxic Acute Lung Injury (HALI) and Ventilator-Induced Lung Injury (VILI). In an attempt to minimize the risk of pulmonary damage, the following hypothesis was raised: Would the association of Eucalyptol inhalation to IMV with a high FiO2 be a suitable measure to decrease the secondary lung injury caused by VILI and HALI during SARS-CoV-2 Disease (COVID-19) treatment? METHODS: In order to answer this question, the use of nebulized Eucalyptol during IMV with 100% FiO2 was investigated, by analyzing respiratory mechanics in vivo and lung histopathology and parenchymal morphometry in vitro. 24 animals were randomly divided into 3 groups: one subjected to 30 minutes of IMV with 21% FiO2 plus nebulized saline (Group 21%+S), one group subjected to 30 minutes of IMV with 100% FiO2 plus nebulized saline (Group 100%+S), and a third group subjected to 30 minutes of IMV plus 100% FiO2 and nebulization with 10 mg/mL Eucalyptol (Group 100%+E). RESULTS: Changes were demonstrated in all respiratory mechanics parameters for the animals in the 100%+S group, as compared with those in the 21%+S group, indicating the presence of secondary lung injury associated with VILI and/or HALI. A statistically significant decrease was also observed for the respiratory mechanics variables of the animals in the 100%+E group when compared with data from the 100%+S group, indicating attenuation of the secondary pulmonary damage due to VILI and/or HALI. CONCLUSION: Treatment with nebulized Eucalyptol at a dose of 10 mg/mL attenuates pulmonary lesions due to HALI and VILI, thus presenting as an attractive option for COVID-19 management in patients under IMV with high values of FiO2.
[ FULL TEXT PDF 1-10 ] DOI: 10.22587/ajbas.2022.16.4.1
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