Hemodynamic Effects of Different Lung-protective Ventilation Strategies in Closed-chest Pigs with Normal Lungs.
From: Department of Intensive Care, Ghent University Hospital, Belgium.
Critical care medicine
- Publish Date: Dec 2006
- ISSN: 0090-3493
- Volume: 34
- Issue: 12
- Pages: 2990-6
- Medium: Print
- Language: English
- Citation (JAMA): Roosens Carl D, Ama Ruggero, Leather H Alex, et al. Hemodynamic Effects of Different Lung-protective Ventilation Strategies in Closed-chest Pigs with Normal Lungs.. Crit. Care Med. Dec 2006;34:2990-6
Abstract
OBJECTIVE: The benefits of lung-protective ventilation strategies used for acute respiratory distress syndrome in subjects with normal lungs are uncertain. The purpose of this study was to investigate the hemodynamic effects of conventional lung-protective ventilation (CLPV) and high-frequency oscillatory ventilation (HFOV) in a normal lung animal model. DESIGN: Prospective laboratory investigation. SETTING: Animal laboratory in a university medical center. SUBJECTS: Seven landrace pigs (mean weight 41 kg). INTERVENTIONS: Pigs were ventilated at random conventionally with positive end-expiratory pressure 2-3 cm H2O and tidal volume 10-12 mL/kg (control), with CLPV (positive end-expiratory pressure 10 cm H2O, tidal volume 6 mL/kg), or with HFOV. Hemodynamics were analyzed after insertion of biventricular conductance catheters and a pulmonary artery catheter. MEASUREMENTS AND MAIN RESULTS: The protective strategies led to higher mean airway pressures and severe hypercapnia with acidosis, which was only significant with CLPV. Compared with control, oxygenation was worse with CLPV and HFOV. With HFOV and CLPV, mean arterial pressure, cardiac output, and stroke volume decreased significantly; pulmonary arterial elastance increased. The slope of the end-diastolic pressure volume relationship for the left and right ventricle remained unchanged (preserved ventricular function), whereas the intercept increased with both protective strategies (augmented intrathoracic pressure); left and right end-diastolic volumes decreased significantly. CONCLUSIONS: In the absence of a fluid resuscitation strategy, CLPV and HFOV caused decreased mean arterial pressure, cardiac output, and stroke volume and worsened oxygenation in this normal lung animal model. This resulted primarily from a biventricular decrease in preload.
Mesh Headings (Keywords): Acidosis, Animals, Blood Pressure, Cardiac Output, High-Frequency Ventilation, Hypercapnia, Positive-Pressure Respiration, Respiration, Artificial, Stroke Volume, Swine, Ventricular Function
Check for Full Text / PubMed Unique Identifier (PMID): 16971849
This abstract is part of PubMed, a service of the U.S. National Library of Medicine. PubMed includes more than 17 million citations from MEDLINE and other life science journals for biomedical articles. See Copyright and Disclaimers.
Linked medical terms appearing on this page are added by Healia to help readers find more information and are not part of the original PubMed document.
The data herein was last updated on July 8th, 2008 and may not reflect the most current and accurate data available from NLM.