Two Methods of Setting Positive End-expiratory Pressure in Acute Lung Injury: An Experimental Computed Tomography Volumetric Study
Journal of Korean Medical Science
;
: 476-483, 2007.
Artículo
en Inglés
| WPRIM
| ID: wpr-109316
ABSTRACT
This study was conducted to observe effects of two methods of setting positive endexpiratory pressure (PEEP) based on the pressure-volume (PV) curve. After lung injury was induced by oleic acid in six mongrel adult dogs, the inflation PV curve was traced and the lower inflection point (LIP) was measured. The 'PEEP(INF)' was defined as LIP+2 cmH2O. After recruitment maneuver to move the lung physiology to the deflation limb of PV curve, decremental PEEP was applied. The lowest level of PEEP that did not result in a significant drop in PaO2 was defined as the 'PEEP(DEF)'. Arterial blood gases, lung mechanics, hemodynamics, and lung volumes (measured on computed tomography during end-expiratory pause) were measured at PEEP of 0 cmH2O, PEEP(INF) and PEEP(DEF) sequentially. The median PEEP(INF) was 13.4 cm H2O (interquartile range, 12.5-14.3) and median PEEP(DEF) was 12.0 cm H2O (10.0-16.5) (p=0.813). PEEP(DEF) was associated with significantly higher PaO2 and lung volumes, and significantly lower shunt fraction and cardiac index when compared to PEEP(INF) (p<0.05). Setting the PEEP based on the deflation limb of the PV curve was useful in improving oxygenation and lung volumes in a canine lung injury model.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Oxígeno
/
Presión
/
Radiografía Torácica
/
Tomografía Computarizada por Rayos X
/
Intercambio Gaseoso Pulmonar
/
Respiración con Presión Positiva
/
Lesión Pulmonar
/
Pulmón
/
Mediciones del Volumen Pulmonar
Límite:
Animales
Idioma:
Inglés
Revista:
Journal of Korean Medical Science
Año:
2007
Tipo del documento:
Artículo
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