Document Detail

Differential lung ventilation with unilateral PEEP following unilateral hydrochloric acid aspiration in the dog.
MedLine Citation:
PMID:  6356757     Owner:  NLM     Status:  MEDLINE    
Differential lung ventilation with positive end expiratory pressure (PEEP) improves pulmonary gas exchange when used in the supportive care of patients with severe unilateral or asymmetrical lung disease. Once the provision of selective PEEP to the two lungs is accomplished, the best method of partitioning the tidal volume between the two lungs is unknown. Twelve mongrel dogs were given a unilateral hydrochloric acid (HCl) aspiration injury. A computer controlled differential lung ventilation system was used to ventilate four dogs with equal volumes to each lung, four dogs with equal driving pressure (end inspiratory pressure-PEEP) to each lung, and four dogs with equal end-tidal CO2 fraction from each lung. The respiratory rate was feedback controlled to maintain PaCO2 at 4.67 kPa. The dogs were kept supine and ventilated with 30% O2. Following injury, the PEEP was set at 0 kPa for 1 h. The dogs were then given 1.36 kPa and 2.72 kPa PEEP to the injured lung for 2 h in a cross-over fashion. The assignment of the tidal volume controller, the side of injury, and the PEEP sequence was random. Oxygen tension fell and pulmonary venous admixture increased after giving the HCl injury. In all three groups considered simultaneously, unilateral PEEP improved PaO2 and venous admixture. The equal tidal volume distribution was the only group to show a significant improvement in PaO2 at both PEEP increments (0 to 1.36 kPa and 2.72 kPa). There was a significant difference in tidal volume allocation between the three groups with the equal end-tidal and equal pause pressure groups only minimally ventilating the injured lung.(ABSTRACT TRUNCATED AT 250 WORDS)
T D East; N L Pace; D R Westenskow; K Lund
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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:  Acta anaesthesiologica Scandinavica     Volume:  27     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  1983 Oct 
Date Detail:
Created Date:  1983-12-20     Completed Date:  1983-12-20     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  356-60     Citation Subset:  IM    
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MeSH Terms
Hydrochloric Acid / adverse effects*
Lung Diseases / physiopathology*
Pneumonia, Aspiration / chemically induced,  physiopathology*
Positive-Pressure Respiration*
Grant Support
Reg. No./Substance:
7647-01-0/Hydrochloric Acid

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

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