| Hemodynamic effects of PEEP in a porcine model of HCl-induced mild acute lung injury. | |
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MedLine Citation:
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PMID: 19094174 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Positive end-expiratory pressure (PEEP) and sustained inspiratory insufflations (SI) during acute lung injury (ALI) are suggested to improve oxygenation and respiratory mechanics. We aimed to investigate the hemodynamic effects of PEEP with and without alveolar recruiting maneuver in a mild ALI model induced by inhalation of hydrochloric acid. METHODS: Thirty-two pigs were randomly allocated into four groups (Control-PEEP, Control-SI, ALI-PEEP and ALI-SI). ALI was induced by intratracheal instillation of hydrochloric acid. PEEP values were progressively increased and decreased from 5, 10, 15 and 20 cmH2O in all groups. Three SIs maneuvers of 30 cmH2O for 20 s were applied to the assignable groups between each PEEP level. Transesophageal echocardiography (TEE), global hemodynamics, oxygenation indexes and gastric tonometry were measured 5 min after the maneuvers had been concluded and at each established value of PEEP (5, 10, 15 and 20 cmH2O). RESULTS: The cardiac index, ejection fraction and end-diastolic volume of right ventricle were significantly (P < 0.001) decreased with PEEP in both Control and ALI groups. Left ventricle echocardiography showed a significant decrease in end-diastolic volume at 20 cmH2O of PEEP (P < 0.001). SIs did not exert any significant hemodynamic effects either early (after 5 min) or late (after 3 h). CONCLUSIONS: In a mild ALI model induced by inhalation of hydrochloric acid, significant hemodynamic impairment characterized by cardiac function deterioration occurred during PEEP increment, but SI, probably due to low applied values (30 cmH2O), did not exert further negative hemodynamic effects. PEEP should be used cautiously in ALI caused by acid gastric content inhalation. |
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Authors:
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C K Marumo; D A Otsuki; D T Fantoni; C B Margarido; A M Ambrósio; P Pelosi; J O C Auler |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2008-12-15 |
Journal Detail:
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Title: Acta anaesthesiologica Scandinavica Volume: 53 ISSN: 1399-6576 ISO Abbreviation: Acta Anaesthesiol Scand Publication Date: 2009 Feb |
Date Detail:
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Created Date: 2009-01-29 Completed Date: 2009-03-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370270 Medline TA: Acta Anaesthesiol Scand Country: England |
Other Details:
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Languages: eng Pagination: 190-202 Citation Subset: IM |
Affiliation:
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Laboratory of Medical Investigation LIM08, Faculdade de Medicina, Universidade de São Paulo, Brazil. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Lung Injury
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blood,
chemically induced,
pathology,
physiopathology,
therapy* Animals Disease Models, Animal Echocardiography, Transesophageal Hemodynamics* Hydrochloric Acid / toxicity Insufflation Lung / pathology Lung Compliance Male Oxygen / blood Partial Pressure Positive-Pressure Respiration* Random Allocation Respiratory Aspiration Single-Blind Method Stroke Volume Sus scrofa Vascular Resistance |
| Chemical | |
Reg. No./Substance:
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7647-01-0/Hydrochloric Acid; 7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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