Effects of spontaneous breathing during airway pressure release ventilation on cerebral and spinal cord perfusion in experimental acute lung injury

Journal of Neurosurgical Anesthesiology
Stefan KreyerRudolf Hering

Abstract

Systemic-blood flow, cerebral-blood flow, and spinal cord blood flow can be affected by mechanical ventilation. We investigated the effect of spontaneous breathing on cerebral and spinal blood flow during airway pressure release ventilation (APRV) with and without spontaneous breathing. Twelve pigs with oleic-acid-induced lung injury were ventilated with APRV with or without spontaneous breathing in random order. Without spontaneous breathing, either the upper airway pressure limit of mechanical ventilation or the ventilator rate was increased to maintain pH and PaCO2 constant. Systemic hemodynamic parameters were determined by the double indicator dilution method, cerebral and spinal cord blood flow was measured with colored microspheres. ANOVA+Newmann-Keuls-test. As compared with APRV without spontaneous breathing and high tidal volume (V(T)) spontaneous breathing during APRV showed higher systemic blood flow and perfusion of the basal ganglia, frontal lobe, hippocampus, brain stem, temporal lobe, thalamus (all P<0.001), cerebellum, spinal cord (all P<0.01), and the central cortical region (P<0.05). During APRV without spontaneous breathing and low V(T) blood flow was lower in the basal ganglia, frontal lobe, hippocampus (all...Continue Reading

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Citations

Jul 26, 2012·Neurocritical Care·Paul E MarikAlex Levitov
Oct 26, 2013·Current Problems in Surgery·Penny Andrews, Nader Habashi
May 24, 2011·Journal of Cardiothoracic and Vascular Anesthesia·Marcin KarczBurkhard Lachmann
May 22, 2016·Intensive Care Medicine Experimental·Sumeet V JainNader M Habashi
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Dec 12, 2017·International Anesthesiology Clinics·Johann PatlakM Dustin Boone
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Jan 10, 2012·Current Opinion in Anaesthesiology·Marcelo Gama de AbreuPaolo Pelosi
Apr 19, 2019·European Respiratory Review : an Official Journal of the European Respiratory Society·Michaela Kollisch-SinguleNader M Habashi

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