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Titolo:
HIGH-FREQUENCY OSCILLATION VERSUS CONVENTIONAL VENTILATION FOLLOWING SURFACTANT ADMINISTRATION AND PARTIAL LIQUID VENTILATION
Autore:
MROZEK JD; BING DR; MEYERS PA; CONNETT JE; MAMMEL MC;
Indirizzi:
CHILDRENS HOSP ST PAUL,DEPT NEONATAL MED,345 N SMITH AVE,RM 2100 ST PAUL MN 55102 CHILDRENS HLTH CARE,INFANT PULM RES CTR ST PAUL MN 00000 UNIV MINNESOTA,DEPT PEDIAT MINNEAPOLIS MN 55455 UNIV MINNESOTA,DEPT BIOSTAT MINNEAPOLIS MN 00000
Titolo Testata:
Pediatric pulmonology
fascicolo: 1, volume: 26, anno: 1998,
pagine: 21 - 29
SICI:
8755-6863(1998)26:1<21:HOVCVF>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
RESPIRATORY-DISTRESS SYNDROME; HYALINE-MEMBRANE DISEASE; POSITIVE-PRESSURE VENTILATION; EXCISED RABBIT LUNGS; MECHANICAL VENTILATION; EXOGENOUS SURFACTANT; GAS-EXCHANGE; PREMATURE BABOONS; INFANTS; THERAPY;
Keywords:
HIGH FREQUENCY VENTILATION; FLUOROCARBONS; MECHANICAL VENTILATION; PULMONARY SURFACTANT; RESPIRATORY DISTRESS SYNDROME; ANIMAL DISEASE MODELS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
43
Recensione:
Indirizzi per estratti:
Citazione:
J.D. Mrozek et al., "HIGH-FREQUENCY OSCILLATION VERSUS CONVENTIONAL VENTILATION FOLLOWING SURFACTANT ADMINISTRATION AND PARTIAL LIQUID VENTILATION", Pediatric pulmonology, 26(1), 1998, pp. 21-29

Abstract

Surfactant followed by partial liquid ventilation (PLV) with perfluorocarbon (PFC; LiquiVent(R)) improves oxygenation, lung compliance, andlung pathology in lung-injured animals receiving conventional ventilation (CV). In this study, we hypothesize that high-frequency oscillation (HFO) and CV will provide equivalent oxygenation in lung-injured animals following surfactant repletion and PLV, once lung volume is optimized. After saline-lavage lung injury during CV, newborn piglets wererandomized to either HFO (n = 10) or CV (n = 9). HFO animals were stabilized over 15 min without optimization of lung volume; CV animals continued treatment with time-cycled, pressure-limited, volume-targeted ventilation. All animals then received 100 mg/kg of surfactant (Survanta(R)). Thirty minutes later, all received intratracheal PFC to approximate functional residual capacity. Thirty minutes after PLV began, mean airway pressure (MAP) in both groups was increased to improve oxygenation. MAP was directly adjusted during HFO; PEEP and PIP were adjusted during IMV, maintaining a pressure sufficient to deliver 15 mL/kg tidal volume. Animals were treated for 4 h. The CV group showed improved oxygenation following surfactant administration (OI: 26.79 +/- 1.98 vs. 8.59 +/- 6.29, P < 0.0004), with little further improvement following PFC administration or adjustments in MAP. Oxygenation in HFO-treated animals did not improve following surfactant, but did improve following PFC (OI: 27.78 +/- 6.84 vs. 15.86 +/- 5.53, P < 0.005) and adjustments in MAP (OI: 15.86 +/- 5.53 vs. 8.96 +/- 2.18, P < 0.03). After MAP adjustments, there were no significant intergroup differences in oxygenation. Animals in the CV group required lower MAP than animals in the HFO group to maintain similar oxygenation. We conclude that surfactant repletion followed by PLV improves oxygenation during both CV andHFO. The initial response to administration of surfactant and PFC wasdifferent for the conventional and high-frequency oscillation groups,likely reflecting the ventilation strategy used; animals in the CV group responded most to surfactant, whereas animals in the HFO group responded most after PFC instillation. The ultimately similar oxygenationof the two groups once lung volume had been optimized suggests that HFO may be used effectively during administration of, and treatment with, surfactant and perfluorocarbon. (C) 1998 Wiley-Liss, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/04/20 alle ore 17:20:56