Document Detail


Effects of positive end-expiratory pressure on regional distribution of tidal volume and recruitment in adult respiratory distress syndrome.
MedLine Citation:
PMID:  7767524     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The distribution of tidal volume (VT) and recruitment was investigated by chest computed tomography (CT) in eight sedated-paralyzed patients with the adult respiratory distress syndrome (ARDS). A CT section was obtained in the supine position at 0, 5, 10, 15, and 20 cm H2O positive end-expiratory pressure (PEEP) and at the corresponding inspiratory plateau pressure (21 +/- 1.8, 26 +/- 1.4, 31 +/- 1.8, 38 +/- 2.1, and 46 +/- 3.2 cm H2O [mean +/- SE]), keeping VT constant. Each CT section was divided along its ventral-dorsal height into 10 equally spaced intervals (levels). Vi(insp) and Vi(exp) were defined as the gas volume for level i (i = 1 to 10) at end-inspiration and at end-expiration, respectively. The following variables were computed at each lung level: (1) distribution of CT section tidal volume (VTct), i.e., the fraction of VT that inflates a given lung level; (2) the plateau-induced and PEEP-induced recruitment, i.e., the amount of lung tissue previously collapsed that inflates at plateau pressure and at PEEP, respectively; (3) the reopening-collapsing tissue, i.e., the amount of lung tissue that regains inflation at plateau pressure and collapses at PEEP. With increasing PEEP from 0 to 20 cm H2O, the VTct distribution decreased significantly (p < 0.01) in the upper levels, did not change in the middle levels, and increased significantly (p < 0.01) in the lower levels.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
L Gattinoni; P Pelosi; S Crotti; F Valenza
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  151     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  1995 Jun 
Date Detail:
Created Date:  1995-06-30     Completed Date:  1995-06-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1807-14     Citation Subset:  AIM; IM    
Affiliation:
Istituto di Anestesia e Rianimazione, IRCCS Universitá degli Studi di Milano, Ospedale Maggiore, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Humans
Lung / physiopathology*,  radiography
Male
Positive-Pressure Respiration* / adverse effects,  methods
Pulmonary Gas Exchange / physiology
Respiratory Distress Syndrome, Adult / physiopathology,  radiography,  therapy*
Tidal Volume / physiology*
Tomography, X-Ray Computed

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