Document Detail


PEEP and low tidal volume ventilation reduce lung water in porcine pulmonary edema.
MedLine Citation:
PMID:  9117033     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study analyzed the effect of both positive end-expiratory pressure (PEEP) and reduction in tidal volume (VT) on extravascular lung water (EVLW) in a permeability model of pulmonary edema. Immediately after producing a pulmonary edema with oleic acid, 21 pigs were randomized into three groups. Group I (n = 8): PEEP of 0 cm H2O (ZEEP), VT of 12 ml/kg; Group II (n = 6): PEEP of 10 cm H2O, VT of 12 ml/kg; Group III (n = 7): PEEP of 10 cm H2O, VT of 6 ml/kg. EVLW was measured by the double indicator method (DI) at baseline (time 0) and after 30, 60, 120, 180, and 240 min and by the gravimetric method (G) at 240 min. Both methods correlated excellently (r = 0.94, p < 0.0001). EVLW-DI was significantly less with PEEP application (Group II versus Group I) at 180 min and thereafter. Likewise, EVLW-DI was less throughout the experimental period with reduced VT once PEEP was applied (Group III versus Group II). EVLW-G was less in Group II than in Group I at 16.3 +/- 2.7 and 23.2 +/- 4.2 ml/kg, respectively (p < 0.0001), and less in Group III than in Group II at 10.7 +/- 0.9 and 16.3 +/- 2.7 ml/kg (p < 0.0001). We conclude that early application of 10 cm H2O of PEEP reduces EVLW in permeability pulmonary edema. The lowering of VT reduced EVLW even further.
Authors:
M Colmenero-Ruiz; E Fernández-Mondéjar; M A Fernández-Sacristán; R Rivera-Fernández; G Vazquez-Mata
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  155     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  1997 Mar 
Date Detail:
Created Date:  1997-04-18     Completed Date:  1997-04-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  964-70     Citation Subset:  AIM; IM    
Affiliation:
Department of Intensive Medicine, Virgin de las Nieves Hospital, Granada, Spain.
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MeSH Terms
Descriptor/Qualifier:
Animals
Disease Models, Animal
Extravascular Lung Water*
Hemodynamics
Permeability
Positive-Pressure Respiration*
Pulmonary Edema / physiopathology,  therapy*
Pulmonary Ventilation*
Respiratory Distress Syndrome, Adult / therapy
Swine
Tidal Volume*
Time Factors

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


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