Document Detail


PEEP decreases atelectasis and extravascular lung water but not lung tissue volume in surfactant-washout lung injury.
MedLine Citation:
PMID:  12897993     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine the effects of positive end-expiratory pressure (PEEP) on extravascular lung water (EVLW), lung tissue, and lung volume. DESIGN AND SETTING: Experimental animal study at a university research facility. SUBJECTS: Fifteen adult sheep. INTERVENTIONS: All animals were studied before and after saline washout-induced lung injury while ventilated with sequentially increasing PEEP (0, 7, 14, or 21 cmH(2)O). MEASUREMENTS AND RESULTS: Lung volume was determined by computed tomography and EVLW by the thermal dye dilution technique. Saline washout significantly increased lung tissue volume (21+/-3 to 37+/-5 ml/kg) and EVLW (9+/-2 to 36+/-9 ml/kg). While increasing levels of PEEP reduced EVLW (30+/-7, 24+/-8, and 18+/-4 ml/kg), lung tissue volume remained constant. Total lung volume significantly increased (50+/-8 ml/kg at PEEP 0 to 77+/-12 ml/kg at PEEP 21). Nonaerated lung volume significantly decreased and was closely correlated with the changes in EVLW ( r=0.67). In addition, a highly significant correlation was found between PEEP-induced decrease in nonaerated lung volume and decrease in transpulmonary shunt ( r=0.83). CONCLUSIONS: The main findings are as follows: (a) PEEP effectively decreases EVLW. (b) The decrease in EVLW is closely correlated with the PEEP-induced decrease in nonaerated lung volume, making EVLW a valuable bedside parameter indicating alveolar recruitment, similar to measurements of transpulmonary shunt. (c) As excess tissue volume remained constant, however, EVLW may not be suitable to reflect overall severity of lung disease
Authors:
Thomas Luecke; Harry Roth; Peter Herrmann; Alf Joachim; Gerald Weisser; Paolo Pelosi; Michael Quintel
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Publication Detail:
Type:  Journal Article     Date:  2003-07-25
Journal Detail:
Title:  Intensive care medicine     Volume:  29     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-11-10     Completed Date:  2004-02-13     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2026-33     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and Critical Care Medicine, Faculty of Clinical Medicine, University Hospital, Theodor-Kutzer-Ufer, 68167, Mannheim, Germany. thomas.Luecke@anaes.ma.uni-heidelberg.de
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MeSH Terms
Descriptor/Qualifier:
Animals
Biological Markers / analysis
Disease Models, Animal*
Dye Dilution Technique
Extravascular Lung Water*
Hemodynamics
Irrigation
Lung Compliance
Lung Volume Measurements*
Positive-Pressure Respiration / methods*
Pulmonary Atelectasis / etiology*,  prevention & control
Pulmonary Circulation
Pulmonary Gas Exchange
Respiratory Distress Syndrome, Adult / chemically induced,  diagnosis,  physiopathology,  therapy*
Respiratory Mechanics
Severity of Illness Index
Sheep
Sodium Chloride
Thermodilution
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
0/Biological Markers; 7647-14-5/Sodium Chloride

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


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