Document Detail


Cardiopulmonary effects of matching positive end-expiratory pressure to abdominal pressure in concomitant abdominal hypertension and acute lung injury.
MedLine Citation:
PMID:  20699747     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: To evaluate the cardiopulmonary effects of positive end-expiratory pressure (PEEP) equalization to intra-abdominal pressure (IAP) in an experimental model of intra-abdominal hypertension (IAH) and acute lung injury (ALI). METHODS: Eight anesthetized pigs were submitted to IAH of 20 mm Hg with a carbon dioxide insufflator for 30 minutes and then submitted to lung lavage with saline and Tween (2.5%). Pressure x volume curves of the respiratory system were performed by a low flow method during IAH and ALI, and PEEP was subsequently adjusted to 27 cm . H2O for 30 minutes. RESULTS: IAH decreases pulmonary and respiratory system static compliances and increases airway resistance, alveolar-arterial oxygen gradient, and respiratory dead space. The presence of concomitant ALI exacerbates these findings. PEEP identical to AP moderately improved oxygenation and respiratory mechanics; however, an important decline in stroke index and right ventricle ejection fraction was observed. CONCLUSIONS: Simultaneous IAH and ALI produce important impairments in the respiratory physiology. PEEP equalization to AP may improve the respiratory performance, nevertheless with a secondary hemodynamic derangement.
Authors:
Juliana Roberta da Silva Almeida; Fabio Santana Machado; Guilherme Paula Pinto Schettino; Marcelo Park; Luciano Cesar Pontes Azevedo
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of trauma     Volume:  69     ISSN:  1529-8809     ISO Abbreviation:  J Trauma     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-11     Completed Date:  2010-09-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  375-83     Citation Subset:  AIM; IM    
Affiliation:
Intensive Care and Anesthesiology Research Laboratory, Research and Education Institute, Hospital Sirio-Libanes, Bela Vista, São Paulo, Brazil.
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MeSH Terms
Descriptor/Qualifier:
Abdominal Cavity / physiopathology*
Acute Lung Injury / physiopathology*,  therapy*
Animals
Compartment Syndromes / physiopathology,  therapy
Disease Models, Animal
Female
Heart Function Tests
Hemodynamics / physiology
Hypertension / physiopathology
Positive-Pressure Respiration / methods*
Pressure*
Probability
Random Allocation
Respiratory Dead Space*
Respiratory Mechanics / physiology
Stroke Volume
Sus scrofa
Vascular Resistance / physiology

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


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