Document Detail


Bronchial blood flow reduction with positive end-expiratory pressure after acute lung injury in sheep.
MedLine Citation:
PMID:  2209046     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Smoke inhalation increases bronchial blood flow (Qbr) and produces edema of the airway system. This study investigates whether the increased Qbr seen 24 h after inhalation injury can be affected by mechanical ventilation with PEEP (5, 10, 15 cm H2O). Sheep (n = 8) previously prepared with cardiopulmonary catheters and ultrasonic transit time flow probes mounted around their bronchial arteries were insufflated with four sets of 12 breaths each of cotton smoke. Different levels of PEEP were added to the mechanical ventilation 24 h after injury; each PEEP level was applied for 45 min. There were significant increases in Qbr and lung lymph flow (QL) associated with a marked decrease in bronchial vascular resistance (BVR) 24 h after injury. However, no change was observed in mean arterial pressure (MAP) or cardiac index (CI). There was a substantial reduction in PaO2/FIO2 (P/F), which indicated a deterioration in arterial oxygenation. The application of varying levels of PEEP decreased Qbr (p less than .05) while BVR increased (p less than .05), but QL and P/F did not. CI and MAP were recorded. After removal of PEEP, none of the cardiopulmonary variables were significantly different from their postsmoke control values. These findings suggest that mechanical ventilation with PEEP markedly decreases the smoke-induced hyperemia edema frequently seen after inhalation injury without any significant alterations in MAP or CI.
Authors:
S Abdi; L D Traber; D N Herndon; G Redl; B Curry; D L Traber
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Critical care medicine     Volume:  18     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  1990 Oct 
Date Detail:
Created Date:  1990-11-02     Completed Date:  1990-11-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1152-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, University of Texas Medical Branch, Galveston.
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Flow Velocity
Blood Gas Analysis
Bronchial Arteries / physiopathology*
Evaluation Studies as Topic
Female
Hemodynamics
Positive-Pressure Respiration / standards*
Pulmonary Circulation*
Sheep
Smoke Inhalation Injury / blood,  physiopathology*,  therapy
Vascular Resistance
Grant Support
ID/Acronym/Agency:
GM 33324/GM/NIGMS NIH HHS; HL 36286/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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