On the crucial ventilatory setting adjustment from two- to one-lung ventilation.

Autor: Ferreira HC; Laboratory of Respiration Physiology, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, RJ, Brazil. hcidrini@gmail.com, Mazzoli-Rocha F, Momesso DP, Garcia CS, Carvalho GM, Lassance-Soares RM, Prota LF, Morales MM, Faffe DS, Carvalho AR, Rocco PR, Zin WA
Jazyk: angličtina
Zdroj: Respiratory physiology & neurobiology [Respir Physiol Neurobiol] 2011 Dec 15; Vol. 179 (2-3), pp. 198-204. Date of Electronic Publication: 2011 Aug 19.
DOI: 10.1016/j.resp.2011.08.006
Abstrakt: Lung mechanics, histology, oxygenation and type-III procollagen (PCIII) mRNA were studied aiming to evaluate the need to readjust ventilatory pattern when going from two- to one-lung ventilation (OLV). Wistar rats were assigned to three groups: the left lung was not ventilated while the right lung received: (1) tidal volume (V(T))=5 ml/kg and positive end-expiratory pressure (PEEP)=2 cm H(2)O (V5P2), (2) V(T)=10 ml/kg and PEEP=2 cm H(2)O (V10P2), and (3) V(T)=5 ml/kg and PEEP=5 cm H(2)O (V5P5). At 1-h ventilation, V5P2 showed hypoxemia, alveolar collapse and impaired lung function. Higher PEEP minimized these changes and prevented hypoxemia. Although high V(T) prevented hypoxemia and maintained a higher specific compliance than V5P2, a morphologically inhomogeneous parenchyma and higher PCIII expression resulted. In conclusion, the association of low V(T) and an adequate PEEP level could be useful to maintain arterial oxygenation without inducing a possible inflammatory/remodeling response.
(Copyright © 2011 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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