Document Detail


Variables used to set PEEP in the lung lavage model are poorly related.
MedLine Citation:
PMID:  10700789     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Setting an appropriate positive end-expiratory pressure (PEEP) value is determined by respiratory mechanics, gas exchange and oxygen transport. As these variables may be optimal at different PEEP values, a unique PEEP value may not exist which satisfies both the demands of minimizing mechanical stress and optimizing oxygen transport. In 15 surfactant-deficient piglets, PEEP was increased progressively. Arterial oxygenation and functional residual capacity (FRC) increased, while specific compliance of the respiratory system decreased. Static compliance increased up to a threshold value of PEEP of 8 cm H2O, after which it decreased. This threshold PEEP did not coincide with the lower inflection point of the inspiratory limb of the pressure-volume (PV) loop. Oxygen transport did not correlate with respiratory mechanics or FRC. In the lavage model, the lower inflection point of the PV curve may reflect opening pressure rather than the pressure required to keep the recruited lung open. Recruitment takes place together with a change in the elastic properties of the already open parts of the lung. No single PEEP level is optimal for both oxygen transport and reduction of mechanical stress.
Authors:
M Lichtwarck-Aschoff; A J Hedlund; K A Nordgren; G A Wegenius; A M Markström; J Guttmann; U H Sjöstrand
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  British journal of anaesthesia     Volume:  83     ISSN:  0007-0912     ISO Abbreviation:  Br J Anaesth     Publication Date:  1999 Dec 
Date Detail:
Created Date:  2000-03-16     Completed Date:  2000-03-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  890-7     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology and Intensive Care, Uppsala University Hospital, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Animals
Bronchoalveolar Lavage
Female
Lung / physiopathology*
Lung Compliance
Lung Volume Measurements
Male
Oxygen / physiology
Positive-Pressure Respiration / adverse effects,  methods*
Residual Volume / physiology
Swine
Chemical
Reg. No./Substance:
7782-44-7/Oxygen
Comments/Corrections
Comment In:
Br J Anaesth. 1999 Dec;83(6):829-32   [PMID:  10700776 ]

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


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