Document Detail


Gas exchange during conventional and high-frequency pulse ventilation in the surfactant-deficient lung: influence of positive end-expiratory pressure.
MedLine Citation:
PMID:  6432439     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
High-frequency pulse ventilation (HFPV) was compared to conventional ventilation (CV) in a model of severe respiratory failure induced by serial lung lavages with warm saline in 8 mongrel dogs. Before the lavage, during HFPV at 4 Hz with a pulse volume (PV) of 125 ml, mean PaO2 was 107 torr and mean PaCO2 was 34 torr. After the last lavage, during CV at an inspired oxygen fraction FIO2 of 1.0 and a tidal volume (VT) of 535 ml, the PaO2 averaged 60 torr and PaCO2 was 45 torr. At an FIO2 of 0.21, 20 cm H2O of positive end-expiratory pressure (PEEP) was applied to prevent hypoxemia. The resulting PaO2 was 87 torr; PaCO2 was 40 torr. Peak airway pressure (Ppa) rose from 21 to 51 cm H2O. When ventilation was switched to HFPV on room air, a PV similar to the control levels was associated with severe hypoxemia (PaO2 less than 45 torr, PaCO2 greater than 50 torr). As PV was increased PaO2 improved, reaching 113 torr at a PV of about 470 ml. The corresponding mean airway pressure (Paw) was about 20 cm H2O. Thus, application of PEEP during HFPV at low PV did not improve PaO2 even when measured Paw approximated 20 cm H2O. This suggests that HFPV with high PV is more effective than either CV with PEEP, or HFPV with low PV and PEEP.
Authors:
G Jibelian; B Lachmann
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Critical care medicine     Volume:  12     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  1984 Sep 
Date Detail:
Created Date:  1984-10-25     Completed Date:  1984-10-25     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  769-73     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Animals
Carbon Dioxide / blood
Disease Models, Animal
Dogs
Irrigation
Oxygen / blood
Positive-Pressure Respiration*
Pulmonary Gas Exchange*
Pulmonary Surfactants / deficiency
Respiration, Artificial / methods*
Respiratory Insufficiency / therapy*
Sodium Chloride / pharmacology
Grant Support
ID/Acronym/Agency:
8604-8//PHS HHS; HL26192-03/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Pulmonary Surfactants; 124-38-9/Carbon Dioxide; 7647-14-5/Sodium Chloride; 7782-44-7/Oxygen

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


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