{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T05:34:23Z","timestamp":1770356063966,"version":"3.49.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec>\n            <jats:title>ABSTRACT<\/jats:title>\n            <jats:p>We previously corroborated benefits of the Trendelenburg position in the prevention of ventilator-associated pneumonia (VAP). We now investigate its potential effects on the brain versus the semirecumbent position. We studied 17 anesthetized pigs and randomized to be ventilated and positioned as follows: duty cycle (T<jats:sub>I<\/jats:sub>\/T<jats:sub>TOT<\/jats:sub>) of 0.33, without positive end-expiratory pressure (PEEP), placed with the bed oriented 30\u00b0 in anti-Trendelenburg (control group); positioned as in the control group, with T<jats:sub>I<\/jats:sub>\/T<jats:sub>TOT<\/jats:sub> adjusted to achieve an expiratory flow bias, PEEP of 5\u200acm H<jats:sub>2<\/jats:sub>O (IRV-PEEP); positioned in 5\u00b0 TP and ventilated as in the control group (TP). Animals were challenged into the oropharynx with <jats:italic toggle=\"yes\">Pseudomonas aeruginosa<\/jats:italic>. We assessed hemodynamic parameters and systemic inflammation throughout the study. After 72\u200ah, we evaluated incidence of microbiological\/histological VAP and brain injury. Petechial hemorrhages score was greater in the TP group (<jats:italic toggle=\"yes\">P<\/jats:italic>\u200a=\u200a0.013). Analysis of the <jats:italic toggle=\"yes\">dentate gyrus<\/jats:italic> showed higher cell apoptosis and deteriorating neurons in TP animals (<jats:italic toggle=\"yes\">P<\/jats:italic>\u200a&lt;\u200a0.05 vs. the other groups). No differences in systemic inflammation were found among groups. Cerebral perfusion pressure was higher in TP animals (<jats:italic toggle=\"yes\">P<\/jats:italic>\u200a&lt;\u200a0.001), mainly driven by higher mean arterial pressure. Microbiological\/histological VAP developed in 0%, 67%, and 86% of the animals in the TP, control, and IRV-PEEP groups, respectively (<jats:italic toggle=\"yes\">P<\/jats:italic>\u200a=\u200a0.003). In conclusion, the TP prevents VAP; yet, we found deleterious neural effects in the <jats:italic toggle=\"yes\">dentate gyrus<\/jats:italic>, likely associated with cerebrovascular modification in such position. Further laboratory and clinical studies are mandatory to appraise potential neurological risks associated with long-term TP.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/shk.0000000000001237","type":"journal-article","created":{"date-parts":[[2018,7,26]],"date-time":"2018-07-26T02:07:50Z","timestamp":1532570870000},"page":"75-82","source":"Crossref","is-referenced-by-count":7,"title":["Hippocampal Damage During Mechanical Ventilation in Trendelenburg Position: A Secondary Analysis of an Experimental Study on the Prevention of Ventilator-Associated Pneumonia"],"prefix":"10.1097","volume":"52","author":[{"given":"Josefina","family":"L\u00f3pez-Aguilar","sequence":"first","affiliation":[{"name":"Critical Care Center, University Hospital Parc Taul\u00ed, Sabadell, Universitat Autonoma de Barcelona, Barcelona, Spain"},{"name":"CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain"},{"name":"Institut d\u2019Investigaci\u00f3 i Innovaci\u00f3 Parc Taul\u00ed (I3PT), Fundaci\u00f3 Parc Taul\u00ed, Sabadell, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluigi Li","family":"Bassi","sequence":"additional","affiliation":[{"name":"CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain"},{"name":"Division of Animal Experimentation, Department of Pulmonary and Critical Care Medicine, Hospital Clinic, Barcelona, Spain"},{"name":"University of Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Elisa","family":"Qu\u00edlez","sequence":"additional","affiliation":[{"name":"Critical Care Center, University Hospital Parc Taul\u00ed, Sabadell, Universitat Autonoma de Barcelona, Barcelona, Spain"},{"name":"CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain"},{"name":"Institut d\u2019Investigaci\u00f3 i Innovaci\u00f3 Parc Taul\u00ed (I3PT), Fundaci\u00f3 Parc Taul\u00ed, Sabadell, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joan Daniel","family":"Mart\u00ed","sequence":"additional","affiliation":[{"name":"Division of Animal Experimentation, Department of Pulmonary and Critical Care Medicine, Hospital Clinic, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Otavio T.","family":"Ranzani","sequence":"additional","affiliation":[{"name":"Division of Animal Experimentation, Department of Pulmonary and Critical Care Medicine, Hospital Clinic, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eli Aguilera","family":"Xiol","sequence":"additional","affiliation":[{"name":"Division of Animal Experimentation, Department of Pulmonary and Critical Care Medicine, Hospital Clinic, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Montserrat","family":"Rigol","sequence":"additional","affiliation":[{"name":"Division of Animal Experimentation, Department of Pulmonary and Critical Care Medicine, Hospital Clinic, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nestor","family":"Luque","sequence":"additional","affiliation":[{"name":"Division of Animal Experimentation, Department of Pulmonary and Critical Care Medicine, Hospital Clinic, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raquel","family":"Guillamat","sequence":"additional","affiliation":[{"name":"CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain"},{"name":"Institut d\u2019Investigaci\u00f3 i Innovaci\u00f3 Parc Taul\u00ed (I3PT), Fundaci\u00f3 Parc Taul\u00ed, Sabadell, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isidre","family":"Ferrer","sequence":"additional","affiliation":[{"name":"Departament de Patologia i Terap\u00e8utica Experimental, Universitat de Barcelona, Barcelona, Spain"},{"name":"Hospital Univesitari de Bellvitge-Idibell, Barcelona, Spain"},{"name":"CIBERNED, Instituto Carlos III, Hospitalet de Llobregat, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antoni","family":"Torres","sequence":"additional","affiliation":[{"name":"CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain"},{"name":"Division of Animal Experimentation, Department of Pulmonary and Critical Care Medicine, Hospital Clinic, Barcelona, Spain"},{"name":"University of Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Llu\u00eds","family":"Blanch","sequence":"additional","affiliation":[{"name":"Critical Care Center, University Hospital Parc Taul\u00ed, Sabadell, Universitat Autonoma de Barcelona, Barcelona, Spain"},{"name":"CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain"},{"name":"Institut d\u2019Investigaci\u00f3 i Innovaci\u00f3 Parc Taul\u00ed (I3PT), Fundaci\u00f3 Parc Taul\u00ed, Sabadell, 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