| Cardiopulmonary effects of matching positive end-expiratory pressure to abdominal pressure in concomitant abdominal hypertension and acute lung injury. | |
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MedLine Citation:
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PMID: 20699747 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Juliana Roberta da Silva Almeida; Fabio Santana Machado; Guilherme Paula Pinto Schettino; Marcelo Park; Luciano Cesar Pontes Azevedo |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Journal of trauma Volume: 69 ISSN: 1529-8809 ISO Abbreviation: J Trauma Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-08-11 Completed Date: 2010-09-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0376373 Medline TA: J Trauma Country: United States |
Other Details:
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Languages: eng Pagination: 375-83 Citation Subset: AIM; IM |
Affiliation:
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Intensive Care and Anesthesiology Research Laboratory, Research and Education Institute, Hospital Sirio-Libanes, Bela Vista, São Paulo, Brazil. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abdominal Cavity
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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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