Document Detail

Pattern of inspiratory gas delivery affects CO2 elimination in health and after acute lung injury.
MedLine Citation:
PMID:  17763841     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To avoid ventilator induced lung injury, tidal volume should be low in acute lung injury (ALI). Reducing dead space may be useful, for example by using a pattern of inspiration that prolongs the time available for gas distribution and diffusion within the respiratory zone, the mean distribution time (MDT). A study was conducted to investigate how MDT affects CO2 elimination in pigs at health and after ALI. DESIGN AND SETTING: Randomised crossover study in the animal laboratory of Lund University Biomedical Center. SUBJECTS AND INTERVENTION: Healthy pigs and pigs with ALI, caused by surfactant perturbation and lung-damaging ventilation were ventilated with a computer-controlled ventilator. With this device each breath could be tailored with respect to insufflation time and pause time (TI and TP) as well as flow shape (square, increasing or decreasing flow). MEASUREMENTS AND RESULTS: The single-breath test for CO2 allowed analysis of the volume of expired CO2 and the volume of CO2 re-inspired from Y-piece and tubes. With a long MDT caused by long TI or TP, the expired volume of CO2 increased markedly in accordance with the MDT concept in both healthy and ALI pigs. High initial inspiratory flow caused by a short TI or decreasing flow increased the re-inspired volume of CO2. Arterial CO2 increased during a longer period of short MDT and decreased again when MDT was prolonged. CONCLUSIONS: CO2 elimination can be enhanced by a pattern of ventilation that prolongs MDT. Positive effects of prolonged MDT caused by short TI and decreasing flow were attenuated by high initial inspiratory flow.
Elisabet Aström; Leif Uttman; Lisbet Niklason; Jerome Aboab; Laurent Brochard; Björn Jonson
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-09-01
Journal Detail:
Title:  Intensive care medicine     Volume:  34     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-05     Completed Date:  2008-06-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  377-84     Citation Subset:  IM    
University Hospital, Department of Clinical Physiology, SE-221 85, Lund, Sweden.
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MeSH Terms
Carbon Dioxide / metabolism*
Cross-Over Studies
Pulmonary Gas Exchange
Random Allocation
Regression Analysis
Respiratory Dead Space
Respiratory Distress Syndrome, Adult / metabolism*
Respiratory Mechanics
Tidal Volume
Reg. No./Substance:
124-38-9/Carbon Dioxide

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

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