Document Detail


The effects of positive end-expiratory pressure in alveolar recruitment during mechanical ventilation in pigs.
MedLine Citation:
PMID:  18641799     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate the effects of alveolar recruitment based on mean airway pressure (MAP) on pig lungs submitted to thoracotomy through blood gas exchange and hemodynamic parameters. METHODS: Twelve pigs weighting approximately 25 Kg were intubated and ventilated on volume controlled ventilation (tidal volume 10 ml/Kg, respiratory rate 16 min, FiO2 1.0, inspiratory:expiratory ratio 1:2, PEEP 5 cmH2O). The animals were then randomized into two groups: control and left lateral thoracotomy. The PEEP was increased at each 15-minute intervals to reach a MAP of 15, 20 and 25 cmH2O, respectively. Hemodynamic, gas exchange and respiratory mechanic data were measured immediately before each PEEP change. RESULTS: There were no significant differences between both groups in all parameters analyzed (P=1.0). The PaO2, PaCO2, MAP, PAP and plateau pressure were significantly worse at MAP of 25 cmH2O, when compared with the other values of MAP (P=0.001, P=0.039, P=0.001, P=0.016 e P=0.027, respectively). The best pulmonary performance according to the analyzed parameters was observed at MAP of 20 cmH2O. CONCLUSION: PEEP adjusted to MAP of 20 cmH2O resulted in best arterial oxygenation, without compromising the venous return, as opposed to MAP of 25 cmH2O, which caused deterioration of gas exchange, hemodynamics and respiratory mechanic.
Authors:
Gabriel Ribeiro Madke; Eduardo Sperb Pilla; Pablo Geraldo Sanchez; Rafael Foernges; Gustavo Grün; Giovani Vendrami; Eduardo Fontena; Cristiano Feijó Andrade; Paulo Francisco Guerreiro Cardoso
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta cirúrgica brasileira / Sociedade Brasileira para Desenvolvimento Pesquisa em Cirurgia     Volume:  23     ISSN:  1678-2674     ISO Abbreviation:  Acta Cir Bras     Publication Date:    2008 Jul-Aug
Date Detail:
Created Date:  2008-07-21     Completed Date:  2009-08-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9103983     Medline TA:  Acta Cir Bras     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  310-4     Citation Subset:  IM    
Affiliation:
FFFCMPA, Brazil. gabrielmadke@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Gas Analysis
Chi-Square Distribution
Disease Models, Animal
Hemodynamics / physiology*
Male
Positive-Pressure Respiration / methods*
Pulmonary Alveoli / blood supply,  physiology*
Pulmonary Gas Exchange / physiology*
Respiration, Artificial / methods*
Respiratory Distress Syndrome, Adult / physiopathology
Swine
Thoracotomy*
Tidal Volume

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


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