| Lung recruitment and positive end-expiratory pressure have different effects on CO2 elimination in healthy and sick lungs. | |
| | |
MedLine Citation:
|
PMID: 20705790 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: We studied the effects that the lung recruitment maneuver (RM) and positive end-expiratory pressure (PEEP) have on the elimination of CO(2) per breath (Vtco(2,br)). METHODS: In 7 healthy and 7 lung-lavaged pigs at constant ventilation, PEEP was increased from 0 to 18 cm H(2)O and then decreased to 0 in steps of 6 cm H(2)O every 10 minutes. Cycling RMs with plateau pressure/PEEP of 40/20 (healthy) and 50/25 (lavaged) cm H(2)O were applied for 2 minutes between 18-PEEP steps. Volumetric capnography, respiratory mechanics, blood gas, and hemodynamic data were recorded. RESULTS: In healthy lungs before the RM, Vtco(2,br) was inversely proportional to PEEP decreasing from 4.0 (3.6-4.4) mL (median and interquartile range) at 0-PEEP to 3.1 (2.8-3.4) mL at 18-PEEP (P < 0.05). After the RM, Vtco(2,br) increased from 3.3 (3-3.6) mL at 18-PEEP to 4.0 (3.5-4.5) mL at 0-PEEP (P < 0.05). In lavaged lungs before the RM, Vtco(2,br) increased initially from 2.0 (1.7-2.3) mL at 0-PEEP to 2.6 (2.2-3) mL at 12-PEEP (P < 0.05) but then decreased to 2.4 (2-2.8) mL when PEEP was increased further to 18 cm H(2)O (P < 0.05). After the RM, the highest Vtco(2,br) of 2.9 (2.1-3.7) mL was observed at 12-PEEP and then decreased to 2.5 (1.9-3.1) mL at 0-PEEP (P < 0.05). Vtco(2,br) was directly related to changes in lung perfusion, the area of gas exchange, and alveolar ventilation but inversely related to changes in dead space. CONCLUSIONS: CO(2) elimination by the lungs was dependent on PEEP and recruitment and showed major differences between healthy and lavaged lungs. |
| | |
Authors:
|
Gerardo Tusman; Stephan H Bohm; Fernando Suarez-Sipmann; Adriana Scandurra; Göran Hedenstierna |
Publication Detail:
|
Type: Comparative Study; Journal Article Date: 2010-08-12 |
Journal Detail:
|
Title: Anesthesia and analgesia Volume: 111 ISSN: 1526-7598 ISO Abbreviation: Anesth. Analg. Publication Date: 2010 Oct |
Date Detail:
|
Created Date: 2010-09-27 Completed Date: 2010-10-11 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 1310650 Medline TA: Anesth Analg Country: United States |
Other Details:
|
Languages: eng Pagination: 968-77 Citation Subset: AIM; IM |
Affiliation:
|
Department of Anesthesiology, Hospital Privado de Comunidad, Mar del Plata, Argentina. gtusman@hotmail.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Animals Blood Gas Analysis / methods Bronchoalveolar Lavage / methods Carbon Dioxide / analysis* Exhalation / physiology* Lung / physiology* Lung Diseases / physiopathology* Lung Volume Measurements / methods Positive-Pressure Respiration / methods* Pulmonary Gas Exchange / physiology Random Allocation Respiratory Mechanics / physiology* Swine |
| Chemical | |
Reg. No./Substance:
|
124-38-9/Carbon Dioxide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: The Effect of Ketamine Anesthesia on the Immune Function of Mice with Postoperative Septicemia.
Next Document: Suppression of spermatogenesis by bisdichloroacetyldiamines is mediated by inhibition of testicular ...