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Titolo:
Application of tracheal gas insufflation to acute unilateral lung injury in an experimental model
Autore:
Blanch, L; Van der Kloot, TE; Youngblood, AM; Murias, G; Naveira, A; Adams, AB; Romero, PV; Nahum, A;
Indirizzi:
Hosp Sabadell, Serv Med Intens, Sabadell 08208, Spain Hosp Sabadell Sabadell Spain 08208 erv Med Intens, Sabadell 08208, Spain Univ Minnesota, Dept Pulm & Crit Care Med, Reg Hosp, St Paul, MN 55108 USAUniv Minnesota St Paul MN USA 55108 Med, Reg Hosp, St Paul, MN 55108 USA Hosp Univ Bellvitge, Serv Pneumol, Barcelona, Spain Hosp Univ Bellvitge Barcelona Spain tge, Serv Pneumol, Barcelona, Spain Hosp Univ Bellvitge, Unitat Recerca Expt, Barcelona, Spain Hosp Univ Bellvitge Barcelona Spain itat Recerca Expt, Barcelona, Spain
Titolo Testata:
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
fascicolo: 4, volume: 164, anno: 2001,
pagine: 642 - 647
SICI:
1073-449X(20010815)164:4<642:AOTGIT>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
RESPIRATORY-DISTRESS SYNDROME; PRESSURE-CONTROL VENTILATION; END-EXPIRATORY PRESSURE; PERMISSIVE HYPERCAPNIA; MECHANICAL VENTILATION; PULMONARY PERFUSION; VOLUME CURVES; TIDAL VOLUME; EXCHANGE; OXYGENATION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
37
Recensione:
Indirizzi per estratti:
Indirizzo: Blanch, L Hosp Sabadell, Serv Med Intens, Corporacio Parc Tauli,Parc TauliS-N, Sabadell 08208, Spain Hosp Sabadell Corporacio Parc Tauli,Parc Tauli S-N Sabadell Spain 08208
Citazione:
L. Blanch et al., "Application of tracheal gas insufflation to acute unilateral lung injury in an experimental model", AM J R CRIT, 164(4), 2001, pp. 642-647

Abstract

In unilateral lung injury, application of global positive end-expiratory pressure (PEEP) may cause overdistension of normal alveoli and redistribution of blood flow to diseased lung areas, thereby worsening oxygenation. We hypothesized that selective application of tracheal gas insufflation (TGI) will recruit the injured lung without causing overdistension of the normal lung. In eight anesthetized dogs, left lung saline lavage was performed until Pa-O2/Fi(O2) fell below 100 mm Hg. Then, the dogs were reintubated with aUnivent single lumen endotracheal tube that incorporates an internal catheter to provide TG I. After injury, increasing PEEP from 3 to 10 cm H2O did not change gas exchange, hemodynamics, or lung compliance. Selective TGI, while keeping end-expiratory lung volume (EELV) constant, improved Pa-O2/Fi(O2) from 212 +/- 43 to 301 +/- 38 mm Hg (p < 0.01) while Pa-CO2 and airway pressures decreased (p < 0.01). During selective TGI, reducing tidal volumeto 5.2 ml/kg while keeping EELV constant, normalized Pa-CO2, did not affect Pa-O2/Fi(O2), and decreased end-inspiratory plateau pressure from 16.6 <plus/minus> 1.0 to 11.9 +/- 0.5 cm H2O (p < 0.01). In unilateral lung injury, we conclude that selective TGI (1) improves oxygenation at a lower pressure cost as compared with conventional mechanical ventilation, (2) allows reduction in tidal volume without a change in alveolar ventilation, and (3) may be a useful adjunct to limit ventilator-associated lung injury.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/04/20 alle ore 07:10:16