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Titolo:
Protective effects of hypercapnic acidosis on ventilator-induced lung injury
Autore:
Broccard, AF; Hotchkiss, JR; Vannay, C; Markert, M; Sauty, A; Feihl, F; Schaller, MD;
Indirizzi:
CHUV, Univ Hosp, Dept Internal Med, Div Intens Care, Lausanne, SwitzerlandCHUV Lausanne Switzerland l Med, Div Intens Care, Lausanne, Switzerland CHUV, Univ Hosp, Cent Lab Clin Chem, Lausanne, Switzerland CHUV LausanneSwitzerland sp, Cent Lab Clin Chem, Lausanne, Switzerland
Titolo Testata:
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
fascicolo: 5, volume: 164, anno: 2001,
pagine: 802 - 806
SICI:
1073-449X(20010901)164:5<802:PEOHAO>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
RESPIRATORY-DISTRESS-SYNDROME; PULMONARY NITRIC-OXIDE; PERMISSIVE HYPERCAPNIA; MECHANICAL VENTILATION; AIRWAY PRESSURE; CARBON-DIOXIDE; RABBIT LUNG; INHIBITION; EXPRESSION; PROTEIN;
Keywords:
respiratory acidosis; hypercapnia; mechanical ventilation; acute lung injury; rabbits;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
32
Recensione:
Indirizzi per estratti:
Indirizzo: Broccard, AF CHU Vaudois, Univ Hosp, Dept Med, Div Soins Intensifs, BH10-982, CH-1011 Lausanne, Switzerland CHU Vaudois BH10-982 Lausanne Switzerland CH-1011 witzerland
Citazione:
A.F. Broccard et al., "Protective effects of hypercapnic acidosis on ventilator-induced lung injury", AM J R CRIT, 164(5), 2001, pp. 802-806

Abstract

To investigate whether respiratory acidosis modulates ventilator-induced lung injury (VILI), we perfused (constant flow) 21 isolated sets of normal rabbit lungs, ventilated them for 20 min (pressure controlled ventilation [PCV] = 15 cm H2O) (Baseline) with an inspired CO2 fraction adjusted for the partial pressure Of CO2 in the perfusate (P-CO2 drop 40 mm Hg), and then randomized them into three groups. Group A (control: n = 7) was ventilated with PCV = 15 cm H2O for three consecutive 20-min periods (T1, T2, T3). In Group B (high PCV/normocapnia; n = 7), PCV was given at 20 (T1), 25 (T2), and30 (T3) cm H2O. The targeted P-CO2 was 40 mm Hg in Groups A and B. Group C(high PCV/hypercapnia; n = 7) was ventilated in the same way as Group B, but the targeted P-CO2 was drop 70 to 100 mm Hg. The changes (from Baseline to T3) in weight gain (Delta WG : g) and in the ultrafiltration coefficient(DeltaK(f) = gr/min/cm H2O/100 g) and the protein and hemoglobin concentrations in bronchoalveolar lavage fluid (BALF) were used to assess injury. Group B experienced a significantly greater Delta WG (14.85 +/- 5.49 [mean +/- SEM] g) and DeltaK(f) (1.40 +/- 0.49 g/min/cm H2O/100 g) than did either Group A (Delta WG = 0.70 +/- 0.43; DeltaK(f) = 0.01 +/- 0.03) or Group C (Delta WG = 5.27 +/- 2.03 g; DeltaK(f) = 0.25 +/- 0.12 g/min/cm H2O/ 100 g). BALF protein and hemoglobin concentrations (g/L) were higher in Group B (11.98 +/- 3.78 g/L and 1.82 +/- 0.40 g/L, respectively) than in Group A (2.92+/- 0.75 g/L and 0.38 +/- 0.15 g/L) or Group C (5.71 +/- 1.88 g/L and 1.19+/- 0.32 g/L). We conclude that respiratory acidosis decreases the severity of VILI in this model.

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Documento generato il 30/05/20 alle ore 14:55:20