| Open Lung Strategy in a Lamb Model of Respiratory Distress Syndrome. | |
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MedLine Citation:
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PMID: 21425032 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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We tested the hypothesis that an open lung strategy with recruitment maneuvers will improve oxygenation and decrease lung injury in comparison with a permissive hypercapnia strategy in preterm lambs. Preterm lambs born by operative delivery at 131 ± 1 days of gestational age (term = 150 days) were randomized to an open lung group (OLG, N = 5) or a permissive hypercapnia group (PHG, N = 4). In the OLG, ramp recruitment maneuvers were performed by increasing and then decreasing peak inspiratory pressure and positive end-expiratory pressure (adjusting for expiratory tidal volume [V (T)] 6 to 8 mL/kg). In the PHG, lambs received ventilation with V (T) of 6 to 8 mL/kg, adapting pressures and respiratory rate according to arterial blood gases results. Fraction of inspired oxygen was adjusted for oxygen saturation 88 to 93%. Lambs were ventilated for 6 hours. Lung pathology was assessed by masked examiners. There were no significant differences for arterial to alveolar oxygen tension ratio, partial pressure of arterial carbon dioxide, blood pressure, compliance, resistance, and other variables between groups. Gas leaks were noted in four of five lambs in the OLG and one of four in the PHG (relative risk 3.2; 95% confidence interval 0.5 to 18). By histological examination, lung areas were overdistended (49% in the OLG, 37% in the PHG). Open lung ventilation following ramp recruitment maneuvers did not offer advantages and might increase lung injury compared with a permissive hypercapnia strategy in preterm lambs with lung immaturity. |
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Authors:
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Gonzalo Luis Mariani; Silvia Fernandez Jonusas; Carlos Maure; Mirta Esteban; Amorina Pardo; Beatriz Rapetti; Carlos Fustiñana |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-3-21 |
Journal Detail:
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Title: American journal of perinatology Volume: - ISSN: 1098-8785 ISO Abbreviation: - Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-3-22 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8405212 Medline TA: Am J Perinatol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© Thieme Medical Publishers. |
Affiliation:
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Division of Neonatology and School of Medicine, Instituto Universitario, Hospital Italiano de Buenos Aires, Gascon, Ciudad de Buenos Aires, Argentina. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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