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Titolo:
Relative roles of vascular and airspace pressures in ventilator-induced lung injury
Autore:
Hotchkiss, JR; Blanch, L; Naveira, A; Adams, AB; Carter, C; Olson, DA; Leo, PH; Marini, JJ;
Indirizzi:
Univ Minnesota, Reg Hosp, Dept Pulm & Crit Care Med, St Paul, MN 55108 USAUniv Minnesota St Paul MN USA 55108 Crit Care Med, St Paul, MN 55108 USA Hosp Sabadell, Serv Med Intens, Corporacio Hosp Parc Tauli, Sabadell, Spain Hosp Sabadell Sabadell Spain orporacio Hosp Parc Tauli, Sabadell, Spain Reg Hosp, Dept Pathol, St Paul, NH USA Reg Hosp St Paul NH USAReg Hosp, Dept Pathol, St Paul, NH USA Univ Minnesota, Dept Aerosp Engn, Minneapolis, MN USA Univ Minnesota Minneapolis MN USA Dept Aerosp Engn, Minneapolis, MN USA
Titolo Testata:
CRITICAL CARE MEDICINE
fascicolo: 8, volume: 29, anno: 2001,
pagine: 1593 - 1598
SICI:
0090-3493(200108)29:8<1593:RROVAA>2.0.ZU;2-2
Fonte:
ISI
Lingua:
ENG
Soggetto:
HYDROSTATIC PULMONARY-EDEMA; ALVEOLAR SURFACE-TENSION; EXCISED DOG LOBES; MECHANICAL VENTILATION; STRESS FAILURE; RABBIT LUNGS; CAPILLARIES; INFLATION; AIRWAY; VOLUME;
Keywords:
mechanical ventilation; hemodynamics; pulmonary circulation; acute lung injury; blood-air barrier; rabbits;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: Hotchkiss, JR Univ Minnesota, Reg Hosp, Dept Pulm & Crit Care Med, St Paul, MN 55108 USA Univ Minnesota St Paul MN USA 55108 , St Paul, MN 55108 USA
Citazione:
J.R. Hotchkiss et al., "Relative roles of vascular and airspace pressures in ventilator-induced lung injury", CRIT CARE M, 29(8), 2001, pp. 1593-1598

Abstract

Objective. To determine whether elevations in pulmonary vascular pressure induced by mechanical ventilation are more injurious than elevations of pulmonary vascular pressure of similar magnitude occurring in the absence of mechanical ventilation. Design: Prospective comparative laboratory investigation. Setting. University research laboratory. Subjects: Male New Zealand white rabbits. Interventions: Three groups of isolated, perfused rabbit lungs were exposed to cyclic elevation of pulmonary artery pressures arising from either intermittent positive pressure mechanical ventilation or from pulsatile perfusion of lungs held motionless by continuous positive airway pressure. Peak, mean, and nadir pulmonary artery pressures and mean airway pressure were matched between groups (35, 27.4 +/- 0.74, and 20.8 +/- 1.5 mm Hg, and 17.7 +/- 0.22 cm H2O, respectively). Measurements and Main Results: Lungs exposed to elevated pulmonary artery pressures attributable to intermittent positive Pressure mechanical ventilation formed more edema (6.8 +/- 1.3 vs. 1.1 +/- 0.9 g/g of lung), displayedmore perivascular (61 +/- 26 vs. 15 +/- 13 vessels) and alveolar hemorrhage (76 +/- 11 % vs. 26 +/- 18% of alveoli), and underwent larger fractional declines in static compliance (88 +/- 4.4% vs. 48 +/- 25.1% decline) than lungs exposed to similar peak and mean pulmonary artery pressures in the absence of tidal positive pressure ventilation. Conclusions: Isolated phasic elevations of pulmonary artery pressure may cause less damage than those occurring during intermittent positive pressuremechanical ventilation, suggesting that cyclic changes in perivascular pressure surrounding extra-alveolar vessels may be important in the genesis ofventilator-induced lung injury.

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Documento generato il 04/04/20 alle ore 21:48:28