Effects of vascular flow and PEEP in a multiple hit model of lung injury in isolated perfused rabbit lungs
| Autor: | John R. Hotchkiss, Lluis Blanch, Ana Villagrá, Josefina López-Aguilar, Alicia Saenz-Valiente, Enrique Piacentini, Gastón Murias, Pilar Fernández-Segoviano, Carolina García-Martín |
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| Rok vydání: | 2008 |
| Předmět: |
Pulmonary Circulation
medicine.medical_treatment Pulmonary Edema Lung injury Pulmonary compliance Critical Care and Intensive Care Medicine Positive-Pressure Respiration medicine Ventilation-Perfusion Ratio Animals Pulmonary Wedge Pressure Pulmonary wedge pressure Positive end-expiratory pressure Mechanical ventilation Respiratory Distress Syndrome Lung business.industry respiratory system Pulmonary edema medicine.disease respiratory tract diseases Disease Models Animal medicine.anatomical_structure Anesthesia Vascular resistance Surgery Rabbits business Oleic Acid |
| Zdroj: | The Journal of trauma. 65(1) |
| ISSN: | 1529-8809 |
| Popis: | Background High vascular flow aggravates lung damage in animal models of ventilator-induced lung injury. Positive end-expiratory pressure (PEEP) can attenuate ventilator-induced lung injury, but its continued effectiveness in the setting of antecedent lung injury is unclear. The objective of the present study was to evaluate whether the application of PEEP diminishes lung injury induced by concurrent high vascular flow and high alveolar pressures in normal lungs and in a preinjury lung model. Methods Two series of experiments were performed. Fifteen sets of isolated rabbit lungs were randomized into three groups (n = 5): low vascular flow/low PEEP; high vascular flow/low PEEP, and high vascular flow/high PEEP. Subsequently, the same protocol was applied in an additional 15 sets of isolated rabbit lungs in which oleic acid was added to the vascular perfusate to produce mild to moderate lung injury. All lungs were ventilated with peak airway pressure of 30 cm H2O for 30 minutes. Outcome measures included frequency of gross structural failure, pulmonary hemorrhage, edema formation, changes in static compliance, pulmonary vascular resistance, and pulmonary ultrafiltration coefficient. Results In the context of high vascular flow, application of a moderate level of PEEP reduced pulmonary rupture, edema formation, and lung hemorrhage. The protective effects of PEEP were not observed in lungs concurrently injured with oleic acid. Conclusions Under these experimental conditions, PEEP attenuates lung injury in the setting of high vascular flow. The protective effect of PEEP is lost in a two-hit model of lung injury. |
| Databáze: | OpenAIRE |
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