Abstract
Objective: To examine the isolated and combined effects of positive end-expiratory pressure (PEEP) and partial liquid ventilation (PLV) on the development of ventilator-induced lung injury in an ovine model. Design: Prospective controlled animal study. Setting: University-based cardiovascular animal physiology laboratory. Subjects: Thirty-eight anesthetized supine sheep weighing 22.3 ± 2.2 kg. Interventions: Animals were ventilated for 6 hrs (respiratory rate, 15; F102, 1.0, inspiratory/expiratory ratio, 1:1) with one of five pressure-controlled strategies, expressed as peak inspiratory pressure (PIP)/PEEP: low-PIP, 25/5 cm H2O (n = 8); high-PIP, 50/5 cm H2O (n = 8); high-PIP-PLV, 50/5 cm H2O-PLV (n = 8); high-PEEP, 50/20 cm H2O (n = 7); and high-PEEP-PLV, 50/20 cm H2O-PLV (n = 7). Measurements and Main Results: Compared with the low-PIP control, high-PIP ventilation increased airleak, shunt, histologic evidence of lung injury, neutrophil infiltrates, and wet lung weight. Maintaining PEEP at 20 cm H2O or adding PLV reduced the development of physiologic shunt and dependent histologic injury indexes. Neither higher PEEP nor PLV reduced the high incidence of barotrauma observed in high-PIP animals. Conclusions: We conclude that application of PLV or PEEP at 20 cm H2O may improve gas exchange and afford lung protection from ventilator-induced lung injury during high-pressure mechanical ventilation in this model.
| Original language | English |
|---|---|
| Pages (from-to) | 182-189 |
| Number of pages | 8 |
| Journal | Critical Care Medicine |
| Volume | 30 |
| Issue number | 1 |
| Publication status | Published - 2002 |
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Keywords
- Barotrauma
- Fluorocarbons
- Mechanical ventilators
- Partial liquid ventilation
- Respiratory insufficiency
- Ventilator-induced lung injury
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine
Cite this
Partial liquid ventilation and positive end-expiratory pressure reduce ventilator-induced lung injury in an ovine model of acute respiratory failure. / Reickert, Craig A.; Rich, Preston B.; Crotti, Stefania; Mahler, Simon A.; Awad, Samir S.; Lynch, William R.; Johnson, Kent J.; Hirschl, Ronald B.
In: Critical Care Medicine, Vol. 30, No. 1, 2002, p. 182-189.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Partial liquid ventilation and positive end-expiratory pressure reduce ventilator-induced lung injury in an ovine model of acute respiratory failure
AU - Reickert, Craig A.
AU - Rich, Preston B.
AU - Crotti, Stefania
AU - Mahler, Simon A.
AU - Awad, Samir S.
AU - Lynch, William R.
AU - Johnson, Kent J.
AU - Hirschl, Ronald B.
PY - 2002
Y1 - 2002
N2 - Objective: To examine the isolated and combined effects of positive end-expiratory pressure (PEEP) and partial liquid ventilation (PLV) on the development of ventilator-induced lung injury in an ovine model. Design: Prospective controlled animal study. Setting: University-based cardiovascular animal physiology laboratory. Subjects: Thirty-eight anesthetized supine sheep weighing 22.3 ± 2.2 kg. Interventions: Animals were ventilated for 6 hrs (respiratory rate, 15; F102, 1.0, inspiratory/expiratory ratio, 1:1) with one of five pressure-controlled strategies, expressed as peak inspiratory pressure (PIP)/PEEP: low-PIP, 25/5 cm H2O (n = 8); high-PIP, 50/5 cm H2O (n = 8); high-PIP-PLV, 50/5 cm H2O-PLV (n = 8); high-PEEP, 50/20 cm H2O (n = 7); and high-PEEP-PLV, 50/20 cm H2O-PLV (n = 7). Measurements and Main Results: Compared with the low-PIP control, high-PIP ventilation increased airleak, shunt, histologic evidence of lung injury, neutrophil infiltrates, and wet lung weight. Maintaining PEEP at 20 cm H2O or adding PLV reduced the development of physiologic shunt and dependent histologic injury indexes. Neither higher PEEP nor PLV reduced the high incidence of barotrauma observed in high-PIP animals. Conclusions: We conclude that application of PLV or PEEP at 20 cm H2O may improve gas exchange and afford lung protection from ventilator-induced lung injury during high-pressure mechanical ventilation in this model.
AB - Objective: To examine the isolated and combined effects of positive end-expiratory pressure (PEEP) and partial liquid ventilation (PLV) on the development of ventilator-induced lung injury in an ovine model. Design: Prospective controlled animal study. Setting: University-based cardiovascular animal physiology laboratory. Subjects: Thirty-eight anesthetized supine sheep weighing 22.3 ± 2.2 kg. Interventions: Animals were ventilated for 6 hrs (respiratory rate, 15; F102, 1.0, inspiratory/expiratory ratio, 1:1) with one of five pressure-controlled strategies, expressed as peak inspiratory pressure (PIP)/PEEP: low-PIP, 25/5 cm H2O (n = 8); high-PIP, 50/5 cm H2O (n = 8); high-PIP-PLV, 50/5 cm H2O-PLV (n = 8); high-PEEP, 50/20 cm H2O (n = 7); and high-PEEP-PLV, 50/20 cm H2O-PLV (n = 7). Measurements and Main Results: Compared with the low-PIP control, high-PIP ventilation increased airleak, shunt, histologic evidence of lung injury, neutrophil infiltrates, and wet lung weight. Maintaining PEEP at 20 cm H2O or adding PLV reduced the development of physiologic shunt and dependent histologic injury indexes. Neither higher PEEP nor PLV reduced the high incidence of barotrauma observed in high-PIP animals. Conclusions: We conclude that application of PLV or PEEP at 20 cm H2O may improve gas exchange and afford lung protection from ventilator-induced lung injury during high-pressure mechanical ventilation in this model.
KW - Barotrauma
KW - Fluorocarbons
KW - Mechanical ventilators
KW - Partial liquid ventilation
KW - Respiratory insufficiency
KW - Ventilator-induced lung injury
UR - http://www.scopus.com/inward/record.url?scp=0036155378&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036155378&partnerID=8YFLogxK
M3 - Article
C2 - 11902260
AN - SCOPUS:0036155378
VL - 30
SP - 182
EP - 189
JO - Critical Care Medicine
JF - Critical Care Medicine
SN - 0090-3493
IS - 1
ER -