Document Detail


Pulmonary effects of positive end-expiratory pressure and fluid therapy in experimental lung injury.
MedLine Citation:
PMID:  21077780     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
ABSTRACT The separate effects of positive end-expiratory pressure (PEEP) and intravascular volume administration on the histopathologic lung injury were not investigated in experimental lung injury previously. The authors hypothesized that high PEEP and a restrictive volume therapy would yield the best oxygenation and the least degree of lung injury. Pigs (52.8 ± 3.4 kg) underwent saline lavage-induced lung injury. The animals were ventilated either with low PEEP (mean PEEP 9 to 12 cm H(2)O) and liberal volume therapy using hydroxyethyl starch (LowP/Vol+) or high PEEP (mean PEEP 21 cm H(2)O) combined with recruitment maneuvers and liberal (HighP/Vol+) or restrictive volume therapy (HighP/Vol-). After 6.5 hours, lung injury was determined by using a histopathologic score evaluating overdistension, edema, exsudation, and inflammation. When volume therapy was liberal, high PEEP (HighP/Vol+) improved the Pao(2)/Fio(2) index (416 ± 80 mm Hg) compared to low PEEP (LowP/Vol+, 189 ± 55 mm Hg; P < .05) but there was no difference in the median (interquartile range) lung injury score: 1.6 (1.2-1.9) and 1.9 (1.4-2.0). High PEEP with restrictive volume therapy (HighP/Vol-) did not further improve oxygenation (400 ± 55 mm Hg) but ameliorated the degree of lung injury: 0.9 (0.8-1.4) (P < .05). In lavage-induced lung injury, high PEEP improved oxygenation, but restrictive volume administration markedly reduced the lung injury score, mainly by reduced edema.
Authors:
Markus Kredel; Ralf M Muellenbach; Nicolas Schlegel; Christian Wunder; Michael Klingelhöfer; Markus Lange; Norbert Roewer; Jens Waschke; Jörg Brederlau
Publication Detail:
Type:  Journal Article     Date:  2010-11-15
Journal Detail:
Title:  Experimental lung research     Volume:  37     ISSN:  1521-0499     ISO Abbreviation:  Exp. Lung Res.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8004944     Medline TA:  Exp Lung Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  35-43     Citation Subset:  IM    
Affiliation:
1Department of Anaesthesia and Critical Care, University of Würzburg, Würzburg, Germany.
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