Effect of lung stress index on titration of positive end-expiratory pressure at post-recruitment in three canine acute respiratory distress syndrome models / 中华外科杂志
Chinese Journal of Surgery
;
(12): 1181-1184, 2006.
Article
Dans Chinois
| WPRIM
| ID: wpr-288627
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the relationship of lung stress index and positive end-expiratory pressure (PEEP) at post-recruitment in different canine acute respiratory distress syndrome (ARDS) models.</p><p><b>METHODS</b>The ARDS models were induced by intravenous oleic acid, saline lavage and hydrochloric acid aspiration in anesthetized dogs. During volume control ventilation with constant inspiratory flow, PEEP was set to obtain a b (stress index) value between 0.9 and 1.1 (b = 1) before and post recruitment maneuver (RM). PEEP was changed to obtain b < 1 (0.6 < b < 0.8) and b > 1 (1.1 < b < 1.3). Meanwhile, the recruited volume (RV) was measured and pulmonary mechanics and gas exchange were observed.</p><p><b>RESULTS</b>At b = 1 after RM, PEEP were (10.8 +/- 2.3), (12.8 +/- 1.8) and (9.2 +/- 1.8) cm H2O in the oleic acid, saline-lavaged and hydrochloric acid aspiration groups, respectively. PEEP in saline-lavaged group was higher than that in hydrochloric acid aspiration group (P < 0.05). The ratio of partial arterial oxygen tension and fraction of inspiratory oxygen (PaO(2)/FiO(2)) at b = 1 without RM was lower than those post-RM in all three groups (P < 0.05). In oleic acid group, PaO(2)/FiO(2) at b = 1 post-RM was (399 +/- 61) mm Hg, which was higher than that at b < 1 [(307 +/- 71) mm Hg], but there was no difference between those at b = 1 and b > 1. At b = 1 after RM, PaO(2)/FiO(2) in the saline-lavaged group was higher than that in acid aspiration group, but no difference between saline-lavaged group and oleic acid group was found. At b = 1 post-RM, RV were higher than that at b = 1 before RM in all three groups (P < 0.01), but there was no significant difference among three groups. At b = 1 post-RM in three groups, pulmonary compliance were higher than those at b > 1, but airway plateau pressure were lower than those at b > 1.</p><p><b>CONCLUSIONS</b>Lung stress index could be a good indicator for PEEP titration at post-RM.</p>
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Pharmacologie
/
/
Tests de la fonction respiratoire
/
Thérapeutique
/
Chlorure de sodium
/
Compliance pulmonaire
/
Ventilation à pression positive
/
Acide oléique
/
Modèles animaux de maladie humaine
/
Acide chlorhydrique
Limites du sujet:
Animaux
langue:
Chinois
Texte intégral:
Chinese Journal of Surgery
Année:
2006
Type:
Article
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