Document Detail

Feasibility and short-term effects of biphasic positive airway pressure versus assist-control ventilation in preterm lambs.
MedLine Citation:
PMID:  19690512     Owner:  NLM     Status:  MEDLINE    
Biphasic positive airway pressure (BiLevel) ventilation allows utilization of two alternating positive end-expiratory pressures (PEEP) while permitting unrestricted spontaneous breathing with superimposed synchronized pressure support. We aimed to compare whether BiLevel versus assist-control (A-C) ventilation provides effective gas exchange and reduces severity of early lung injury in preterm lambs. Preterm lambs delivered at 134 d (term = 150 d) were quasirandomized to BiLevel (PEEP low/high 5/20 cm H2O) or A-C5 (PEEP 5 cm H2O) ventilation. Ventilation parameters and arterial blood gases were recorded at regular intervals. Postmortem measurements included pressure-volume relationship, lung inflammatory score, wet/dry body weight ratio, and messenger RNA (mRNA) expression of early markers of lung injury. There were no significant differences between groups in baseline characteristics, oxygenation index (p = 0.49), or partial pressure of carbon dioxide (Paco2) (p = 0.08). BiLevel group lambs showed improved pressure-volume relationship (p = 0.006), lower lung inflammatory score (p = 0.013), and trend toward lower messenger RNA expression of markers of lung injury compared with A-C5 group lambs. In unsedated preterm lambs, BiLevel ventilation provides gas exchange equivalent to A-C ventilation and potentially results in reduced lung injury.
Sven M Schulzke; Graeme R Polglase; Foula Sozo; J Jane Pillow
Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatric research     Volume:  66     ISSN:  1530-0447     ISO Abbreviation:  Pediatr. Res.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-18     Completed Date:  2010-03-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  665-70     Citation Subset:  IM    
School of Women's and Infant's Health, University of Western Australia, Crawley, Western Australia 6009, Australia.
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MeSH Terms
Continuous Positive Airway Pressure / methods*
Lung Injury / metabolism,  pathology,  therapy*
Polymerase Chain Reaction
Premature Birth
Pulmonary Gas Exchange / physiology*
RNA, Messenger / metabolism
Reg. No./Substance:
0/RNA, Messenger

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