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Two methods of setting positive end-expiratory pressure in acute lung injury: an experimental computed tomography volumetric study.
| Content Provider | Europe PMC |
|---|---|
| Author | Jeon, Kyeongman Jeon, Ik Soo Suh, Gee Young Chung, Man Pyo Koh, Won-Jung Kim, Hojoong Kwon, O Jung Han, Dai-Hee Chung, Myung Jin Lee, Kyung Soo |
| Copyright Year | 2007 |
| Abstract | This study was conducted to observe effects of two methods of setting positive end-expiratory pressure (PEEP) based on the pressure-volume (PV) curve. After lung injury was induced by oleic acid in six mongrel adult dogs, the inflation PV curve was traced and the lower inflection point (LIP) was measured. The 'PEEPINF' was defined as LIP+2 cmH2O. After recruitment maneuver to move the lung physiology to the deflation limb of PV curve, decremental PEEP was applied. The lowest level of PEEP that did not result in a significant drop in PaO2 was defined as the 'PEEPDEF'. Arterial blood gases, lung mechanics, hemodynamics, and lung volumes (measured on computed tomography during end-expiratory pause) were measured at PEEP of 0 cmH2O, PEEPINF and PEEPDEF sequentially. The median PEEPINF was 13.4 cm H2O (interquartile range, 12.5-14.3) and median PEEPDEF was 12.0 cm H2O (10.0-16.5) (p=0.813). PEEPDEF was associated with significantly higher PaO2 and lung volumes, and significantly lower shunt fraction and cardiac index when compared to PEEPINF (p<0.05). Setting the PEEP based on the deflation limb of the PV curve was useful in improving oxygenation and lung volumes in a canine lung injury model. |
| ISSN | 10118934 |
| Volume Number | 22 |
| PubMed Central reference number | PMC2693641 |
| Issue Number | 3 |
| PubMed reference number | 17596657 |
| Journal | Journal of Korean Medical Science [J. Korean Med. Sci] |
| e-ISSN | 15986357 |
| DOI | 10.3346/jkms.2007.22.3.476 |
| Language | English |
| Publisher | The Korean Academy of Medical Sciences |
| Publisher Date | 2007-06-01 |
| Access Restriction | Open |
| Rights License | This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright © 2007 The Korean Academy of Medical Sciences |
| Subject Keyword | Acute Respiratory Distress Syndrome Positive-pressure Respiration Pressure-volume Curve Computed Tomography |
| Content Type | Text |
| Resource Type | Article |
| Subject | Medicine |
