Document Detail


Effects of spontaneous breathing during airway pressure release ventilation on cerebral and spinal cord perfusion in experimental acute lung injury.
MedLine Citation:
PMID:  20622682     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Systemic-blood flow, cerebral-blood flow, and spinal cord blood flow can be affected by mechanical ventilation. We investigated the effect of spontaneous breathing on cerebral and spinal blood flow during airway pressure release ventilation (APRV) with and without spontaneous breathing.
METHODS: Twelve pigs with oleic-acid-induced lung injury were ventilated with APRV with or without spontaneous breathing in random order. Without spontaneous breathing, either the upper airway pressure limit of mechanical ventilation or the ventilator rate was increased to maintain pH and PaCO2 constant. Systemic hemodynamic parameters were determined by the double indicator dilution method, cerebral and spinal cord blood flow was measured with colored microspheres. Statistics: ANOVA+Newmann-Keuls-test.
RESULTS: As compared with APRV without spontaneous breathing and high tidal volume (V(T)) spontaneous breathing during APRV showed higher systemic blood flow and perfusion of the basal ganglia, frontal lobe, hippocampus, brain stem, temporal lobe, thalamus (all P<0.001), cerebellum, spinal cord (all P<0.01), and the central cortical region (P<0.05). During APRV without spontaneous breathing and low V(T) blood flow was lower in the basal ganglia, frontal lobe, hippocampus (all P<0.01), and temporal lobe (P<0.05) whereas perfusion of the thalamus, central cortical region, brain stem, cerebellum, and spinal cord were not different compared with APRV with spontaneous breathing.
CONCLUSIONS: In parallel with higher systemic blood flow regional cerebral and spinal cord blood flow were also higher when spontaneous breathing was maintained during APRV. The higher regional blood flow by maintaining spontaneous breathing was more pronounced when compared with full ventilatory support using high V(T).
Authors:
Stefan Kreyer; Christian Putensen; Andreas Berg; Martin Soehle; Thomas Muders; Herrmann Wrigge; Jörg Zinserling; Rudolf Hering
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgical anesthesiology     Volume:  22     ISSN:  1537-1921     ISO Abbreviation:  J Neurosurg Anesthesiol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-16     Completed Date:  2011-01-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8910749     Medline TA:  J Neurosurg Anesthesiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  323-9     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and Intensive Care Medicine, University of Bonn, Bonn, Germany. Stefan.Kreyer@ukb.uni-bonn.de
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MeSH Terms
Descriptor/Qualifier:
Acute Lung Injury / chemically induced,  physiopathology*
Animals
Body Temperature
Cerebrovascular Circulation / physiology*
Heart Rate / physiology
Hemodynamics / physiology
Hemoglobins / metabolism
Oleic Acid
Oxygen / blood
Positive-Pressure Respiration
Pulmonary Gas Exchange / physiology
Regional Blood Flow / physiology
Respiration*
Respiration, Artificial*
Respiratory Mechanics / physiology
Spinal Cord / blood supply*
Swine
Tidal Volume / physiology
Chemical
Reg. No./Substance:
0/Hemoglobins; 112-80-1/Oleic Acid; 7782-44-7/Oxygen

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


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