Pulmonary gas distribution during ventilation with different inspiratory flow patterns in experimental lung injury -- a computed tomography study

Acta Anaesthesiologica Scandinavica
H RothM Quintel

Abstract

There is still controversy about the optimal inspiratory flow pattern for ventilation of patients with acute lung injury. The aim of this study was to compare the effects of pressure-controlled ventilation (PCV) with a decelerating inspiratory flow with volume-controlled ventilation (VCV) with constant inspiratory flow on pulmonary gas distribution (PGD) in experimentally induced ARDS. Sixteen adult sheep were randomized to be ventilated with PCV or VCV after surfactant depletion by repeated bronchoalveolar lavage. Positive end-expiratory pressure (PEEP) was increased in a stepwise manner from zero end-expiratory pressure (ZEEP) to 7, 14 and 21 cm H(2)O in hourly intervals. Respiratory rate, inspiration-to-expiration ratio and tidal volume were kept constant. Central hemodynamics, gas exchange and airway pressures were measured. Electron beam computed tomographic (EBCT) scans of the entire lungs were performed at baseline (preinjury) and each level of end-expiratory pressure during an inspiratory and expiratory hold maneuver. The lungs were three-dimensionally reconstructed and volumetric assessments were made separating the lungs into four subvolumes classified as overinflated, normally aerated, poorly aerated and nonaerated. ...Continue Reading

References

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Citations

Aug 11, 2007·Critical Care : the Official Journal of the Critical Care Forum·Alysson Roncally S CarvalhoAntonio Giannella-Neto
Mar 27, 2010·Respiratory Physiology & Neurobiology·Vittorio AntonagliaWalter A Zin
Mar 21, 2007·Critical Care Clinics·Dane Nichols, Sai Haranath
Aug 11, 2012·Respiratory Physiology & Neurobiology·Vittorio AntonagliaWalter A Zin
Sep 18, 2015·Anesthesia and Analgesia·Carlos Ferrando, Francisco Javier Belda
Sep 17, 2020·Biomedical Engineering Online·Mojdeh Monjezi, Hamidreza Jamaati
Mar 12, 2011·Journal of Applied Physiology·Gaetano PerchiazziGöran Hedenstierna

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