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Titolo:
Protective effects of low tidal volume ventilation in a rabbit model of Pseudomonas aeruginosa-induced acute lung injury
Autore:
Savel, RH; Yao, EC; Gropper, MA;
Indirizzi:
Univ Calif San Francisco, Dept Anesthesia & Perioperat Care, San Francisco, CA 94143 USA Univ Calif San Francisco San Francisco CA USA 94143 ancisco, CA 94143 USA
Titolo Testata:
CRITICAL CARE MEDICINE
fascicolo: 2, volume: 29, anno: 2001,
pagine: 392 - 398
SICI:
0090-3493(200102)29:2<392:PEOLTV>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
RESPIRATORY-DISTRESS-SYNDROME; ALVEOLAR EPITHELIAL INJURY; END-EXPIRATORY PRESSURE; MECHANICAL VENTILATION; ESCHERICHIA-COLI; PULMONARY-EDEMA; CANINE MODEL; PNEUMONIA; MORTALITY; FAILURE;
Keywords:
acute lung injury; Pseudomonas aeruginosa; mechanical ventilation; ventilator induced injury; blood-air barrier; extravascular lung water; rabbits; bacterial pneumonia; sepsis syndrome; tidal volume; acute respiratory distress syndrome;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
44
Recensione:
Indirizzi per estratti:
Indirizzo: Gropper, MA Univ Calif San Francisco, Dept Anesthesia & Perioperat Care, San Francisco, CA 94143 USA Univ Calif San Francisco San Francisco CA USA 94143 94143 USA
Citazione:
R.H. Savel et al., "Protective effects of low tidal volume ventilation in a rabbit model of Pseudomonas aeruginosa-induced acute lung injury", CRIT CARE M, 29(2), 2001, pp. 392-398

Abstract

Objective: To determine whether low "stretch" mechanical ventilation protects animals from clinical sepsis after direct acute lung injury with Pseudomonas aeruginosa as compared with high "stretch" ventilation. Design: Prospective study. Setting: Experimental animal laboratory. Subjects: Twenty-seven anesthetized and paralyzed rabbits. Interventions: P. aeruginosa (10(9) colony forming units) was instilled into the right lungs of rabbits that were then ventilated at a tidal volume of either 15 mL/kg (n = 11) or 6 mL/kg (n = 7) for 8 hrs.: Control animals were ventilated at a tidal volume of either 15 mL/kg (n = 4) or 6 mL/kg (n =5) for 8 hrs, but an instillate without bacteria was used. A positive end-expiratory pressure of 3-5 cm H2O was used for all experiments. Radiolabeled albumin was used as a marker of alveolar epithelial permeability. Measurements and Main Results: Hemodynamics, arterial blood-gas determination, alveolar permeability, wet-to-dry ratios on lungs, and time course of bacteremia were determined. When final: values were compared with the values at the beginning of the experiment, there were significant decreases in mean arterial pressure (from 104 +/- 15 to 57 +/- 20 mm Hg), pH (from 7.46 +/- 0.04 to 7.24 +/- 15), Pao(2) (from 528 +/- 35 to 129 +/- 104 torr [70.4 /- 4.7 to 17.2 +/- 13.9 kPa]), and temperature (from 38.2 +/- 1 to 36.2 +/- 1.2 degreesC) in the high tidal volume group, whereas no significant differences were found in the low tidal volume group. Decreased alveolar permeability was shown in the low tidal volume group, as was decreased extravascular lung water in the uninstilled lung in the low tidal volume group (12.7 /- 2.5 vs. 4.3 +/- 0.45 g H2O/g dry lung). No noteworthy difference was noted in the time course of bacteremia, although there was a trend toward earlier bacteremia in the high tidal volume group. Conclusions: In our animal model of P. aeruginosa-induced acute lung injury, low tidal volume ventilation was correlated with improved oxygenation, hemodynamic status, and acid-base status as well as decreased alveolar permeability and contralateral extravascular lung water.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/03/20 alle ore 10:51:31