| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Guest Access | Sign In via User Name/Password
|
|
|
|||||||
Guest Access | Sign In via User Name/Password |
|||||||||
1 From the Istituto di Anestesia e Rianimazione, Universitá di Milano, Servizio di Anestesia e Rianimazione, Ospedale S. Gerardo, Monza (MI), Italy
Study objective: To study the effect of positive end-expiratory pressure (PEEP) on the decay of respiratory system compliance (Cpl,rs) due to low tidal volume (VT) ventilation in acute lung injury (ALI) patients.
Setting: General ICU in a university hospital.
Participants: Eight ALI patients with a lung injury score greater than 2.5.
Interventions: Pressure-controlled ventilation (PCV) and volume-controlled ventilation (VCV), with an average VT of 8.5±0.4 mL/kg, were applied at three levels of PEEP (5, 10, and 15 cm H2O). Before each PCV and VCV period, lung volume history was standardized by manual hyperinflation maneuvers.
Measurements: We measured Cpl,rs at time 0 (start), 10, 20, and 30 (end) min from the beginning of each PCV and VCV period. Gas exchange and hemodynamic data were collected at end.
Results: At PEEP 5 and 10 cm H2O, we observed a progressive Cpl,rs decay with both PCV and VCV modes. At PEEP 5 cm H2O, we detected a higher Cpl,rs decrease during PCV, due to a higher Cpl,rs at start, compared with VCV. At PEEP 15 cm H2O, Cpl,rs did not decrease significantly. Cpl,rs values measured at end as well as oxygenation and hemodynamic data did not differ between PCV and VCV. At PEEP 15 cm H2O, PCV provided lower PaCO2 than VCV.
Conclusions: A PEEP of at least 15 cm H2O was needed to prevent Cpl,rs decay. The progressive Cpl,rs loss we observed at lower PEEP probably reflects alveolar instability.
Key Words: acute lung injury • mechanical ventilation • positive end-expiratory pressure • respiratory mechanics • respiratory system compliance
Submitted on July 5, 1995
Accepted on September 15, 2007
This article has been cited by other articles:
|
|
 |
|
  M. Lichtwarck-Aschoff, B. Suki, A. Hedlund, U. H. Sjostrand, A. Markstrom, R. Kawati, G. Hedenstierna, and J. Guttmann Decreasing size of cardiogenic oscillations reflects decreasing compliance of the respiratory system during long-term ventilation J Appl Physiol, March 1, 2004; 96(3): 879 - 884. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Rylander, M. Hogman, G. Perchiazzi, A. Magnusson, and G. Hedenstierna Functional Residual Capacity and Respiratory Mechanics as Indicators of Aeration and Collapse in Experimental Lung Injury Anesth. Analg., March 1, 2004; 98(3): 782 - 789. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Allen and J. H. T. Bates Dynamic mechanical consequences of deep inflation in mice depend on type and degree of lung injury J Appl Physiol, January 1, 2004; 96(1): 293 - 300. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.-C. RICHARD, S. M. MAGGIORE, B. JONSON, J. MANCEBO, F. LEMAIRE, and L. BROCHARD Influence of Tidal Volume on Alveolar Recruitment . Respective Role of PEEP and a Recruitment Maneuver Am. J. Respir. Crit. Care Med., June 1, 2001; 163(7): 1609 - 1613. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. De Robertis, J.M. Liu, S. Blomquist, P.L. Dahm, J. Thorne, and B. Jonson Elastic properties of the lung and the chest wall in young and adult healthy pigs Eur. Respir. J., April 1, 2001; 17(4): 703 - 711. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. B. Zwischenberger, S. K. Alpard, and A. Bidani Severe respiratory failure Ann. Thorac. Surg., January 1, 2001; 71(1): 394 - 396. [Full Text] [PDF]
|
|
|
|
|
|
L. BROCHARD, F. ROUDOT-THORAVAL, E. ROUPIE, C. DELCLAUX, J. CHASTRE, E. FERNANDEZ-MONDEJAR, E. CLEMENTI, J. MANCEBO, P. FACTOR, D. MATAMIS, et al. Tidal Volume Reduction for Prevention of Ventilator-induced Lung Injury in Acute Respiratory Distress Syndrome Am. J. Respir. Crit. Care Med., December 1, 1998; 158(6): 1831 - 1838. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
