Partial liquid ventilation and positive end-expiratory pressure reduce ventilator-induced lung injury in an ovine model of acute respiratory failure
| Autor: | Stefania Crotti, Kent J. Johnson, Preston B. Rich, Simon A. Mahler, Craig A. Reickert, Samir S. Awad, William R. Lynch, Ronald B. Hirschl |
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| Rok vydání: | 2002 |
| Předmět: |
Mechanical ventilation
Artificial ventilation Liquid Ventilation Sheep Ventilators Mechanical business.industry medicine.medical_treatment Positive pressure Peak inspiratory pressure respiratory system Lung injury Critical Care and Intensive Care Medicine respiratory tract diseases Positive-Pressure Respiration Disease Models Animal Intensive care Anesthesia Acute Disease medicine Breathing Animals Respiratory Insufficiency business Lung Positive end-expiratory pressure |
| Zdroj: | Critical Care Medicine. 30:182-189 |
| ISSN: | 0090-3493 |
| DOI: | 10.1097/00003246-200201000-00026 |
| Popis: | Objective: To examine the isolated and combined effects of positive end-expiratory pressure (PEEP) and partial liquid ventilation (PLV) on the development of ventilator-induced lung injury in an ovine model. Design: Prospective controlled animal study. Setting: University-based cardiovascular animal physiology laboratory. Subjects: Thirty-eight anesthetized supine sheep weighing 22.3 ± 2.2 kg. Interventions: Animals were ventilated for 6 hrs (respiratory rate, 15; FIO 2 , 1.0, inspiratory/expiratory ratio, 1:1) with one of five pressure-controlled strategies, expressed as peak inspiratory pressure (PIP)/PEEP: low-PIP, 25/5 cm H 2 O (n = 8); high-PIP, 50/5 cm H 2 O (n = 8); high-PIP-PLV, 50/5 cm H 2 O-PLV (n = 8); high-PEEP, 50/20 cm H 2 O (n = 7); and high-PEEP-PLV, 50/20 cm H 2 O-PLV (n = 7). Measurements and Main Results: Compared with the low-PIP control, high-PIP ventilation increased airleak, shunt, histologic evidence of lung injury, neutrophil infiltrates, and wet lung weight. Maintaining PEEP at 20 cm H 2 O or adding PLV reduced the development of physiologic shunt and dependent histologic injury indexes. Neither higher PEEP nor PLV reduced the high incidence of barotrauma observed in high-PIP animals. Conclusions: We conclude that application of PLV or PEEP at 20 cm H 2 O may improve gas exchange and afford lung protection from ventilator-induced lung injury during high-pressure mechanical ventilation in this model. |
| Databáze: | OpenAIRE |
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