Document Detail

Alveolar edema dispersion and alveolar protein permeability during high volume ventilation: effect of positive end-expiratory pressure.
MedLine Citation:
PMID:  17333114     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To evaluate whether PEEP affects intrapulmonary alveolar edema liquid movement and alveolar permeability to proteins during high volume ventilation. DESIGN AND SETTING: Experimental study in an animal research laboratory. SUBJECTS: 46 male Wistar rats. INTERVENTIONS: A (99m)Tc-labeled albumin solution was instilled in a distal airway to produce a zone of alveolar flooding. Conventional ventilation (CV) was applied for 30 min followed by various ventilation strategies for 3 h: CV, spontaneous breathing, and high volume ventilation with different PEEP levels (0, 6, and 8 cmH(2)O) and different tidal volumes. Dispersion of the instilled liquid and systemic leakage of (99m)Tc-albumin from the lungs were studied by scintigraphy. MEASUREMENTS AND RESULTS: The instillation protocol produced a zone of alveolar flooding that stayed localized during CV or spontaneous breathing. High volume ventilation dispersed alveolar liquid in the lungs. This dispersion was prevented by PEEP even when tidal volume was the same and thus end-inspiratory pressure higher. High volume ventilation resulted in the leakage of instilled (99m)Tc-albumin from the lungs. This increase in alveolar albumin permeability was reduced by PEEP. Albumin permeability was more affected by the amplitude of tidal excursions than by overall lung distension. CONCLUSIONS: PEEP prevents the dispersion of alveolar edema liquid in the lungs and lessens the increase in alveolar albumin permeability due to high volume ventilation.
Nicolas de Prost; Damien Roux; Didier Dreyfuss; Jean-Damien Ricard; Dominique Le Guludec; Georges Saumon
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-03-02
Journal Detail:
Title:  Intensive care medicine     Volume:  33     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-03-26     Completed Date:  2007-07-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  711-7     Citation Subset:  IM    
Centre de Recherche Bichat Beaujon CRB3, INSERM U773, site Bichat BP 416, Université Paris 7, Denis Diderot, 75018, Paris, France.
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MeSH Terms
Positive-Pressure Respiration*
Pulmonary Alveoli / drug effects
Pulmonary Edema / etiology,  radionuclide imaging,  therapy*
Rats, Wistar
Respiration, Artificial
Technetium Tc 99m Aggregated Albumin / pharmacology
Tidal Volume
Reg. No./Substance:
0/Technetium Tc 99m Aggregated Albumin

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