Document Detail


Cardiovascular responses to high-frequency oscillatory ventilation during acute lung injury in sheep.
MedLine Citation:
PMID:  17680186     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The present study was designed to evaluate pulmonary and systemic hemodynamics and blood gas changes on switching from conventional mechanical ventilation (CMV) to high-frequency oscillatory ventilation (HFOV) in a large animal model of acute lung injury. METHODS: Eleven anesthetised sheep chronically instrumented with vascular monitoring were prepared. Animals received oleic acid (0.08 ml x kg(-1)) intravenously and were ventilated for 4 h h after the administration of oleic acid. The animals were then randomized into the two following different ventilation modes: CMV (tidal volume [V(T)], 6 ml x kg(-1); respiratory rate [RR], 25 x min(-1)) with positive end-expiratory pressure (PEEP) of 12 cmH(2)O; or CMV under the same settings without PEEP. HFOV was then switched. The setting of mean airway pressure with a fixed stroke volume was changed between 25, 18, and 12 cmH(2)O every 20 min. Mean pulmonary artery pressure, pulmonary artery occlusive pressure (Paop), left atrium pressure, systemic arterial pressure, cardiac output (CO), and blood gas composition under each setting were measured before and after HFOV. RESULTS: Switching to HFOV, from without PEEP, resulted in significant increases in Paop and PaO2 and a decrease in CO at higher (25, 18 cmH(2)O) mean airway pressure. However, when changed from low V(T) and PEEP, HFOV produced further improvements in oxygenation without any deterioration of cardiovascular depression. Thus, switching to HFOV from CMV with low V(T) and high PEEP may have little influence on pulmonary or systemic hemodynamics in acute lung injury. CONCLUSION: We conclude that hemodynamic responses are dependent on the predefined setting of PEEP during CMV, and on applied mean airway pressure during HFOV.
Authors:
Rikimaru Nakagawa; Tomonobu Koizumi; Koichi Ono; Kenji Tsushima; Sumiko Yoshikawa; Keishi Kubo; Tetutarou Otagiri
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2007-08-01
Journal Detail:
Title:  Journal of anesthesia     Volume:  21     ISSN:  0913-8668     ISO Abbreviation:  J Anesth     Publication Date:  2007  
Date Detail:
Created Date:  2007-08-07     Completed Date:  2007-10-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8905667     Medline TA:  J Anesth     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  340-7     Citation Subset:  IM    
Affiliation:
Anesthesiology and Resuscitation, Shinshu University School of Medicine, Matsumoto, Japan.
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Animals
Blood Gas Analysis
Blood Pressure / physiology*
Cardiac Output / physiology*
Disease Models, Animal
High-Frequency Ventilation / methods*
Oleic Acid
Positive-Pressure Respiration / methods*
Random Allocation
Respiratory Distress Syndrome, Adult / blood,  chemically induced,  therapy*
Sheep
Vascular Resistance / physiology*
Chemical
Reg. No./Substance:
112-80-1/Oleic Acid

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


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