Threshold estimation and superthreshold behavior of ultrasound-induced lung hemorrhage in rats: role of age dependency

Anesthetic techniques influence the induction of pulmonary capillary hemorrhage during diagnostic ultrasound scanning in rats

OBJECTIVES

Pulmonary capillary hemorrhage can be induced by diagnostic ultrasound (US) during direct pulmonary US scanning in rats. The influence of specific anesthetic techniques on this bioeffect was examined.

METHODS

Ketamine plus xylazine has been used previously. In this study, the influence of intraperitoneal injections of ketamine and pentobarbital, inhalational isoflurane, and the supplemental use of xylazine with ketamine and isoflurane was tested. A diagnostic US machine with a 7.6-MHz linear array was used to image the right lung of anesthetized rats in a warmed water bath at different mechanical index (MI) settings. Pulmonary capillary hemorrhage was assessed by measuring comet tail artifacts in the image and by morphometry of the hemorrhagic areas on excised lungs.

RESULTS

Pulmonary capillary hemorrhage was greatest for pentobarbital, lower for inhalational isoflurane, and lowest for ketamine anesthesia, with occurrence thresholds at MIs of about 0.44, 0.8, and 0.8, respectively. Addition of xylazine produced a substantial increase in hemorrhage and a significant proportion of hemorrhage occurrence for ketamine at an MI of 0.7 (P < .01) and for isoflurane at an MI of 0.52 (P < .01).

CONCLUSIONS

Ketamine plus xylazine and pentobarbital yield lower thresholds than ketamine or isoflurane alone by nearly a factor of 2 in MI. These results suggest that the choice of the anesthetic agent substantially modifies the relative risks of pulmonary capillary hemorrhage from pulmonary US.

Estimation of the acoustic impedance of lung versus level of inflation for different species and ages of animals

In a previous study, it was hypothesized that ultrasound-induced lung damage was related to the transfer of ultrasonic energy into the lungs (W. D. O'Brien et al. 2002, "Ultrasound-induced lung hemorrhage: Role of acoustic boundary conditions at the pleural surface," J. Acoust. Soc. Am. 111, 1102-1109). From this study a technique was developed to: 1) estimate the impedance (Mrayl) of fresh, excised, ex vivo rat lung versus its level of inflation (cm H(2)O) and 2) predict the fraction of ultrasonic energy transmitted into the lung (M. Oelze et al. 2003, "Impedance measurements of ex vivo rat lung at different volumes of inflation." J. Acoust. Soc. Am. 114, 3384-3393). In the current study, the same technique was used to estimate the frequency-dependent impedance of lungs from rats, rabbits, and pigs of various ages. Impedance values were estimated from lungs under deflation (atmospheric pressure, 0 cm H(2)O) and three volumes of inflation pressure [7 cm H(2)O (5 cm H(2)O for pigs), 10 cm H(2)O, and 15 cm H(2)O]. Lungs were scanned in a tank of degassed 37 degrees C water. The frequency-dependent acoustic pressure reflection coefficient was determined over a frequency range of 3.5-10 MHz. From the reflection coefficient, the frequency-dependent lung impedance was calculated with values ranging from an average of 1.4 Mrayl in deflated lungs (atmospheric pressure) to 0.1 Mrayl for fully inflated lungs (15 cm H(2)O). Across all species, deflated lung (i.e., approximately 7% of the total lung capacity) had impedance values closer to tissue values, suggesting that more acoustic energy was transmitted into the lung under deflated conditions. Finally, the impedance values of deflated lungs from different species at different ages were compared with the thresholds for ultrasound-induced lung damage. The comparison revealed that increases in ultrasonic energy transmission corresponded to lower injury threshold values.