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Evaluation of the parameters of protective mechanical ventilation on the renal function of obese animals: renal consequences of prolonged treatment

Grant number: 20/13405-2
Support type:Regular Research Grants
Duration: February 01, 2022 - January 31, 2024
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal researcher:Fernanda Teixeira Borges
Grantee:Fernanda Teixeira Borges
Home Institution: Pró-Reitoria de Pós-Graduação e Pesquisa. Universidade Cruzeiro do Sul (UNICSUL). São Paulo , SP, Brazil

Abstract

Worldwide obesity is considered a top public health concern. Currently, another top public health concern is the coronavirus 2 of the severe acute respiratory syndrome (SARS-Cov-2), responsible for the current pandemic of COVID-19, and the mechanical ventilation (MV) has been an essential ally in the treatment of SARS associated with infection. However, it is known that MV can induce changes in renal function and trigger acute kidney injury (AKI), and this mortality in the intensive care unit (ICU) ranges from 50% to 90%. Worryingly obese undergoing MV has a prevalence of AKI twice as high when compared to non-obese individuals. Concerningly, in Brazil, more than half of the obese people who died due to COVID-19 were under the age of 60, making obesity the leading risk factor for people under this age in the country. On the other hand, few studies in the literature assess IV-parameters, such as positive end-expiratory pressure (PEEP) in prolonged periods in obese patients and their influence on renal function. Therefore, our objective is to compare different PEEP-parameters and periods in an obesity model and its impact on renal function in control and obese rats with SARS through model of Lachmann et al. In addition to the kidney, we will also evaluate in the lung and in the adipose tissue the four potential mechanisms of susceptibility suggested for obese infected with the COVID-19, without the interference of the viral load of COVID-19, which are: (1) blood clotting disorder; (2) cellular senescence that could facilitate increased viral load; (3) the expression of ACE2, the gateway to the virus in the respiratory system, that could offer a higher viral reservoir and (4) the inflammatory state of the organism, with the assessment of inflammatory markers IL-6 and TNF-± and anti-inflammatory IL -10. Thus, we can assess the greater susceptibility of the obese to the disease. (AU)

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