Positive end-expiratory pressure and ventilation inhomogeneity in mechanically ventilated children

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
Andreas Schibler, Robert Henning

Abstract

OBJECTIVE: To obtain optimal titration of positive end-expiratory pressure (PEEP) during mechanical ventilation with functional residual capacity and ventilation homogeneity measurements. DESIGN: Experimental human and animal study. INTERVENTIONS: Functional residual capacity and five indices of uneven ventilation (alveolar mean dilution number, mean dilution number, lung clearance index, mixing ratio, and pulmonary clearance delay) were investigated in 22 children aged 0 to 14 yrs with lung disease and in seven rabbits by using a sulfur-hexafluoride wash-out technique. The children and rabbits were exposed to three different levels of PEEP (0, 5, and 10 cm H(2)O for the children and 0, 3 and 6 cm H(2)O for the rabbits). RESULTS: Functional residual capacity of the children increased from 256.9 +/- 178.6 mL (0 PEEP) to 280.0 +/- 201.1 mL (5 PEEP) and to 302.2 +/- 160.4 mL (10 PEEP, p <.001). Ventilation inhomogeneity decreased significantly in all children with increasing PEEP (p <.05). The alveolar mean dilution number decreased from 2.00 +/- 0.29 (0 PEEP) to 1.82 +/- 0.37 (5 PEEP) and to 1.66 +/- 0.34 (10 PEEP), and pulmonary clearance delay decreased from 74.9 +/- 24.2% to 66.6 +/- 38.1% and to 63.9 +/- 24.2%, respectively. ...Continue Reading

Associated Clinical Trials

Apr 19, 2021·Jin-Tae Kim, Jin-Tae Kim

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Citations

Aug 7, 2010·Intensive Care Medicine·Peter A DargavilleInéz Frerichs
May 25, 2010·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Britta S von Ungern-Sternberg, Walid Habre
Oct 9, 2013·Korean journal of anesthesiology·Hee Jong LeeEun Sun Cho
Nov 3, 2007·The Journal of Thoracic and Cardiovascular Surgery·Britta S von Ungern-SternbergUNKNOWN Swiss Paediatric Respiratory Research Group
Aug 6, 2008·Pediatric Pulmonology·S M SchulzkeJ J Pillow
Apr 24, 2007·Anaesthesia·A RegliUNKNOWN Swiss Paediatric Respiratory Research Group
Jan 30, 2009·Acta Anaesthesiologica Scandinavica·L F Maracajá-NetoM A Lessa
Dec 22, 2009·Pediatric Pulmonology·Sanjay SinhalJ Jane Pillow
Jun 13, 2006·Paediatric Respiratory Reviews·Andreas Schibler
Apr 16, 2016·Paediatric Respiratory Reviews·Gerd Schmalisch
Jun 3, 2015·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Guillaume EmeriaudUNKNOWN Pediatric Acute Lung Injury Consensus Conference Group
Jul 22, 2016·British Journal of Anaesthesia·D TrachselB S von Ungern-Sternberg
Jul 15, 2020·The Ultrasound Journal·Cecilia M AcostaGerardo Tusman
Jun 28, 2020·Anaesthesia·C Lyons, M Callaghan
Nov 12, 2019·Frontiers in Pediatrics·Donna FranklinUNKNOWN PARIS and PREDICT
Apr 26, 2021·BMC Pulmonary Medicine·Mikuláš MlčekOtomar Kittnar

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