Document Detail


Gas exchange and lung inflammation using nasal intermittent positive-pressure ventilation versus synchronized intermittent mandatory ventilation in piglets with saline lavage-induced lung injury: an observational study.
MedLine Citation:
PMID:  18090370     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Physiologic and pathologic comparison of two modes of assisted ventilation, nasal intermittent positive-pressure ventilation (NIPPV) and synchronized intermittent mandatory ventilation (SIMV), in spontaneously breathing term newborn piglets with saline lavage-induced lung injury. DESIGN: After inducing acute lung injury via repetitive saline lavage, piglets were randomized to NIPPV (n = 12) or SIMV (n = 11) and treated for 6 hrs. SETTING: Clinical laboratory. SUBJECTS: Spontaneously breathing term newborn piglets. INTERVENTIONS: Invasive (SIMV) or noninvasive (NIPPV) assisted ventilation for 6 hrs. MEASUREMENTS: Physiologic parameters and arterial blood gases were continuously monitored. At the conclusion of the study, lung tissue was obtained to analyze for evidence of inflammation, including myeloperoxidase, interleukin-8, and hydrogen peroxide levels, as well as for evidence of pathologic injury. MAIN RESULTS: Piglets treated with NIPPV demonstrated higher arterial blood gas pH (p < .001), lower PaCO2 (p < .05), and a lower set respiratory rate (p < .0001) as compared with the SIMV-treated piglets. The piglets in the SIMV group had higher PaO2/PaO2 ratio than those in the NIPPV group (p = .001). There was significantly more interstitial inflammation (p = .04) in the SIMV-treated piglets compared with the NIPPV-treated piglets. Total respiratory rate, heart rate, blood pressure, oxygen saturation, and biochemical markers of lung inflammation were not different between the groups. CONCLUSION: In surfactant-deficient term newborn piglets, NIPPV offers an effective and noninvasive ventilatory strategy with the potential for less pathologic lung inflammation.
Authors:
Andrea L Lampland; Patricia A Meyers; Cathy T Worwa; Elizabeth C Swanson; Mark C Mammel
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  36     ISSN:  1530-0293     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-03     Completed Date:  2008-02-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  183-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, Division of Neonatology, University of Minnesota Medical School, Minneapolis, MN, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Bronchoalveolar Lavage
Disease Models, Animal
Intermittent Positive-Pressure Ventilation / methods*
Pneumonia / metabolism*,  physiopathology
Pulmonary Gas Exchange*
Random Allocation
Respiratory Distress Syndrome, Adult / metabolism*,  physiopathology,  therapy*
Sodium Chloride
Swine
Chemical
Reg. No./Substance:
7647-14-5/Sodium Chloride
Comments/Corrections
Comment In:
Crit Care Med. 2008 Jan;36(1):349-50   [PMID:  18158453 ]

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


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