| Effects of positive end-expiratory pressure on regional distribution of tidal volume and recruitment in adult respiratory distress syndrome. | |
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MedLine Citation:
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PMID: 7767524 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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) |
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Authors:
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L Gattinoni; P Pelosi; S Crotti; F Valenza |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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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:
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Created Date: 1995-06-30 Completed Date: 1995-06-30 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9421642 Medline TA: Am J Respir Crit Care Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1807-14 Citation Subset: AIM; IM |
Affiliation:
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Istituto di Anestesia e Rianimazione, IRCCS Universitá degli Studi di Milano, Ospedale Maggiore, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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