Document Detail


Effect of positive end-expiratory pressure on regional ventilation distribution during bronchoconstriction in rabbit studied by synchrotron radiation imaging.
MedLine Citation:
PMID:  21494104     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE:: To assess the effects of positive end-expiratory pressure on regional ventilation distribution in normal lung and after histamine-induced bronchoconstriction. DESIGN:: Experimental study. SETTING:: International research laboratory. SUBJECTS:: Six healthy New Zealand rabbits weighing 2.5 ± 0.1 kg. INTERVENTIONS:: Rabbits were anesthetized, tracheostomized, paralyzed, and mechanically ventilated. Synchrotron radiation computed tomography images of tissue density and specific ventilation were acquired using K-edge subtraction imaging with inhaled stable xenon gas in middle and caudal thoracic levels on 0 and 5 cm H2O positive end-expiratory pressure at baseline and twice after histamine inhalation. MEASUREMENTS AND MAIN RESULTS:: At baseline, a positive end-expiratory pressure of 5 cm H2O significantly increased lung volume. Histamine inhalation caused patchy areas of decreased specific ventilation, including some areas with no ventilation. After histamine, positive end-expiratory pressure significantly increased the area of well-ventilated lung regions and decreased the heterogeneity of specific ventilation. This improvement went together with a significant but limited increase in the area of hyperinflated lung zones. CONCLUSIONS:: The findings of this study suggest that in mechanically ventilated rabbit with severely heterogeneous bronchoconstriction, a positive end-expiratory pressure of 5 cm H2O significantly improves regional ventilation homogeneity through dilation of flow-limited airways and recruitment of closed airways.
Authors:
Liisa Porra; Heikki Suhonen; Pekka Suortti; Anssi R A Sovijärvi; Sam Bayat
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-24
Journal Detail:
Title:  Critical care medicine     Volume:  -     ISSN:  1530-0293     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-4-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the European Synchrotron Radiation Facility (LP, HS), Grenoble, France; the Department of Physics (LP, PS), University of Helsinki, Helsinki, Finland; the Department of Clinical Physiology and Nuclear Medicine (ARAS), Helsinki University Central Hospital, Helsinki, Finland; and Université de Picardie Jules Vern (SB), EA4285 Péritox UMI01 INERIS and CHU Amiens, Amiens, France.
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