Effect of using several levels of positive end-expiratory pressure over barotrauma's induced lung injury in a model of isolated and perfused rabbit lungs

Humberto Trejo; Daniela Urich; Alejandro Pezzulo; Eva Novoa; Héctor Marcano; Astrid Crespo; Roberto Sánchez de León

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Effect of using several levels of positive end-expiratory pressure over barotrauma's induced lung injury in a model of isolated and perfused rabbit lungs

Journal article

Peer reviewed

Effect of using several levels of positive end-expiratory pressure over barotrauma's induced lung injury in a model of isolated and perfused rabbit lungs

Humberto Trejo, Daniela Urich, Alejandro Pezzulo, Eva Novoa, Héctor Marcano, Astrid Crespo and Roberto Sánchez de León

Investigación clínica, Vol.47(1), pp.49-64

03/2006

PMID: 16562644

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Abstract

The use of Positive end-expiratory pressure (PEEP) as a strategy of mechanical ventilation offers its advantages, such as improved oxygenation, without causing alveolar overstretching and barotrauma. We aim to investigate the effect of several levels of PEEP on barotrauma and, whether an optimal level of PEEP exists. Forty-eight New Zealand rabbits (2.5-3.5 kg) were divided into four groups with PEEP settings of 0, 4, 8 and 12 cmH2O, at increasing levels of inspiratory volume (IV). This was done in blood perfused rabbit lungs and in lungs perfused with a Buffer-Albumin Solution. We observed that lungs ventilated with PEEP 0 cmH2O suffered pulmonary rupture at high IV (300cc), with significant increases of Pap (Pulmonary artery pressure) and FFR (Fluid filtration rate). Lungs ventilated with PEEP 8 and 12 suffered pulmonary rupture at lower IV (200cc and 150cc vs. 300cc respectively) On the other hand, lungs ventilated with PEEP 4 cmH2O reached the highest IV (400cc), in addition, they showed the lowest elevations of Pap and FFR. The acellular lungs ventilated with PEEP 4, 8 and 12 showed pulmonary rupture at lower IV when compared with cellular ones (300cc vs. 400cc: 100cc vs. 200cc and 100cc vs. 150cc respectively). We concluded that an optimal PEEP exists, which protects against barotrauma, however, excess of PEEP could enhance its development. The blood could contain some mediators which attenuate the damage induced by barotrauma.

Rabbits

Animals

Positive-Pressure Respiration - adverse effects

Lung Injury

Positive-Pressure Respiration - methods

In Vitro Techniques

Barotrauma - therapy

Details

Title: Subtitle: Effect of using several levels of positive end-expiratory pressure over barotrauma's induced lung injury in a model of isolated and perfused rabbit lungs
Creators: Humberto Trejo - Sección de Fisiología Respiratoria, Instituto de Medicina Experimental, Facultad de Medicina, Escuela de Medicina "Luis Razetti", Universidad Central de Venezuela, Caracas, Venezuela
Daniela Urich
Alejandro Pezzulo
Eva Novoa
Héctor Marcano
Astrid Crespo
Roberto Sánchez de León
Resource Type: Journal article
Publication Details: Investigación clínica, Vol.47(1), pp.49-64
PMID: 16562644
NLM abbreviation: Invest Clin
ISSN: 0535-5133
Alternative title: Estudio del efecto de las variaciones de la Presión Positiva Espiratoria Final en el daño pulmonar inducido por barotrauma en un modelo de pulmones de conejo aislados y perfundidos
Language: Spanish
Date published: 03/2006
Academic Unit: Pulmonary, Critical Care, and Occupational Medicine; Iowa Neuroscience Institute; Internal Medicine
Record Identifier: 9984094602102771

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