| Combination of arteriovenous extracorporeal lung assist and high-frequency oscillatory ventilation in a porcine model of lavage-induced acute lung injury: a randomized controlled trial. | |
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MedLine Citation:
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PMID: 17297323 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: To compare the combined effects of arteriovenous extracorporeal lung assist (AV-ECLA) and high-frequency oscillatory ventilation (HFOV) on pulmonary gas exchange, hemodynamics, and respiratory parameters in a lavage-induced porcine lung injury model. METHODS: A prospective, randomized animal study. Saline lung lavage was performed in 33 healthy female pigs, weighing 52 +/- 4.1 kg (mean +/- SD), until the Pao2 decreased to 53 +/- 8 mm Hg. After a stabilization period of 60 minutes, the animals were randomly assigned to four groups: group 1, pressure-controlled ventilation (PCV) with a tidal volume of 6 mL/kg; group 2, PCV with a tidal volume of 6 mL/kg and AV-ECLA; group 3, HFOV; group 4, HFOV and AV-ECLA. In groups 2 and 4, the femoral artery and vein were cannulated and a low-resistance membrane lung was interposed. After isolated evaluation of AV-ECLA, the mean airway pressure was increased by 3 cm H2O from 16 to 34 cm H2O every 20 minutes, accompanied by blood gas analyses and measurements of respiratory and hemodynamic variables. RESULTS: Only in AV-ECLA-treated animals was normocapnia achieved. No significant increase of Pao2 attributable to AV-ECLA alone was detected. Mean airway pressure augmentation resulted in a significant increase in Pao2 in all groups. Peak inspiratory pressure was significantly lower in HFOV-treated animals. CONCLUSIONS: The combination of AV-ECLA and HFOV resulted in normocapnia and comparable Pao2, although a smaller ventilator pressure amplitude was applied. Long-term animal studies are needed to assess whether this approach results in further lung protection. |
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Authors:
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Joerg Brederlau; Ralf Muellenbach; Markus Kredel; Julian Kuestermann; Martin Anetseder; Clemens Greim; Norbert Roewer |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: The Journal of trauma Volume: 62 ISSN: 0022-5282 ISO Abbreviation: J Trauma Publication Date: 2007 Feb |
Date Detail:
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Created Date: 2007-02-13 Completed Date: 2007-03-15 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: 336-46; discussion 345-6 Citation Subset: AIM; IM |
Affiliation:
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Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Würzburg, Würzburg, Germany. brederlau_j@klinik.uni-wuerzburg.de |
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| MeSH Terms | |
Descriptor/Qualifier:
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Analysis of Variance Animals Bronchoalveolar Lavage / adverse effects* Combined Modality Therapy Disease Models, Animal Extracorporeal Membrane Oxygenation* High-Frequency Ventilation* Prospective Studies Pulmonary Gas Exchange Respiratory Distress Syndrome, Adult / therapy* Swine |
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