BACKGROUND: Different levels of positive end-expiratory pressure (PEEP) with and without a recruitment maneuver (RM) may have a significant impact on ventilator-induced lung injury but this issue has not been well addressed. METHODS: Anesthetized rats received hydrochloric acid (HCl, pH 1.5) aspiration, followed by mechanical ventilation with a tidal volume of 6 ml/kg. The animals were randomized into four groups of 10 each: (1) high PEEP at 6 cm H(2)O with an RM by applying peak airway pressure at 30 cm H(2)O for 10 s every 15 min; (2) low PEEP at 2 cm H(2)O with RM; (3) high PEEP alone; and (4) low PEEP alone. RESULTS: The mean arterial pressure and the amounts of fluid infused were similar in the four groups. Application of the higher PEEP improved oxygenation compared with the lower PEEP groups (P<0.05). The lung compliance was better reserved, and the systemic cytokine responses and lung wet to dry ratio were lower in the high PEEP than in the low PEEP group for a given RM (P<0.05). CONCLUSIONS: The use of a combination of periodic RM and the higher PEEP had an additive effect in improving oxygenation and pulmonary mechanics and attenuation of inflammation.
BACKGROUND: Different levels of positive end-expiratory pressure (PEEP) with and without a recruitment maneuver (RM) may have a significant impact on ventilator-induced lung injury but this issue has not been well addressed. METHODS: Anesthetized rats received hydrochloric acid (HCl, pH 1.5) aspiration, followed by mechanical ventilation with a tidal volume of 6 ml/kg. The animals were randomized into four groups of 10 each: (1) high PEEP at 6 cm H(2)O with an RM by applying peak airway pressure at 30 cm H(2)O for 10 s every 15 min; (2) low PEEP at 2 cm H(2)O with RM; (3) high PEEP alone; and (4) low PEEP alone. RESULTS: The mean arterial pressure and the amounts of fluid infused were similar in the four groups. Application of the higher PEEP improved oxygenation compared with the lower PEEP groups (P<0.05). The lung compliance was better reserved, and the systemic cytokine responses and lung wet to dry ratio were lower in the high PEEP than in the low PEEP group for a given RM (P<0.05). CONCLUSIONS: The use of a combination of periodic RM and the higher PEEP had an additive effect in improving oxygenation and pulmonary mechanics and attenuation of inflammation.
Authors: Stephen H Loring; Matteo Pecchiari; Patrizia Della Valle; Ario Monaco; Guendalina Gentile; Edgardo D'Angelo Journal: Crit Care Med Date: 2010-12 Impact factor: 7.598
Authors: Nuria E Cabrera-Benítez; Matteo Parotto; Martin Post; Bing Han; Peter M Spieth; Wei-Erh Cheng; Francisco Valladares; Jesús Villar; Mingayo Liu; Masaaki Sato; Haibo Zhang; Arthur S Slutsky Journal: Crit Care Med Date: 2012-02 Impact factor: 7.598
Authors: Stephen H Loring; Carl R O'Donnell; Negin Behazin; Atul Malhotra; Todd Sarge; Ray Ritz; Victor Novack; Daniel Talmor Journal: J Appl Physiol (1985) Date: 2009-12-17
Authors: Chin-Ming Chen; Oscar Penuelas; Kieran Quinn; Kuo-Chen Cheng; Chien-Feng Li; Haibo Zhang; Arthur S Slutsky Journal: Crit Care Med Date: 2009-07 Impact factor: 7.598
Authors: Laura A Cagle; Lisa M Franzi; Angela L Linderholm; Jerold A Last; Jason Y Adams; Richart W Harper; Nicholas J Kenyon Journal: PLoS One Date: 2017-11-07 Impact factor: 3.240