The effects of positive end-expiratory pressure in alveolar recruitment during mechanical ventilation in pigs

Acta Cirurgica Brasileira

Gabriel Ribeiro Madke²  Eduardo Sperb Pilla²  Pablo Geraldo Sanchez¹  Rafael Foernges¹  Gustavo Grün¹  Giovani Vendrami¹  Eduardo Fontena¹  Cristiano Feijó Andrade¹  Paulo Francisco Guerreiro Cardoso¹ 

[1] ,FFFCMPA

关键词: Respiration;    Artificial;    Positive-Pressure Respiration;    Pulmonary Alveoli;    Swine;    Respiração Artificial;    Respiração com Pressão Positiva;    Alvéolos Pulmonares;    Suínos;   

DOI  :  10.1590/S0102-86502008000400003

来源: SciELO

【 摘 要 】

PURPOSE: To evaluate the effects of alveolar recruitment based on mean airway pressure (MAP) on pig lungs submitted to thoracotomy through blood gas exchange and hemodynamic parameters. METHODS: Twelve pigs weighting approximately 25Kg were intubated and ventilated on volume controlled ventilation (tidal volume 10ml/Kg, respiratory rate 16min, FiO2 1.0, inspiratory:expiratory ratio 1:2, PEEP 5cmH2O). The animals were then randomized into two groups: control and left lateral thoracotomy. The PEEP was increased at each 15-minute intervals to reach a MAP of 15, 20 and 25cmH2O, respectively. Hemodynamic, gas exchange and respiratory mechanic data were measured immediately before each PEEP change. RESULTS: There were no significant differences between both groups in all parameters analyzed (P=1.0). The PaO2, PaCO2, MAP, PAP and plateau pressure were significantly worse at MAP of 25cmH2O, when compared with the other values of MAP (P=0.001, P=0.039, P=0.001, P=0.016 e P=0.027, respectively). The best pulmonary performance according to the analyzed parameters was observed at MAP of 20cmH2O. CONCLUSION: PEEP adjusted to MAP of 20cmH2O resulted in best arterial oxygenation, without compromising the venous return, as opposed to MAP of 25cmH2O, which caused deterioration of gas exchange, hemodynamics and respiratory mechanic.

【 授权许可】

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