Introduction: Debate on optimal ventualory strategies te Acme Lung Injury (AU) conriimrs We compared the effects of 2 ventuatory strategies on pahnonary mechanics and endothrlial fimction in rabbit ALI model Our hypothesis is that ventilatory strategy does not affect pulmonary endothelial fimction in the presence of ALL Methods: Male NZW rabbits (36-52 kg.) were n-ahurâpf and mechanically ventilated with a Siemens 900. The rabbits were stratified into 2 groups. The high tidal vohimeCVJ group (iF-11), V, of 15 ml/kg, PEEP of 4cm HjO. The low V, group (n7) used i V, of Srnl/kg. PEEP of 8cm HjO strategy. Hemodynamk, pahnonary parameters and ABG vahies were recorded hourly. After baaebne imamiements phorbol myristate acetate (PMA; 20 pg/kg) was injected into a central vein. Pahnonary nucrovascular endothelial function was determined by the transpulmonary metabolism of [3H]-Benzoyi-Phe-Ala-Pro, an angiotensin converting enzyvw (ACE) substrate. Mcasuroncjits were obtained at baseline 2 and 4 hours. Results were analyzed using ANOVA and Duscan's test, with giuuy comparisons by t-lest. Results: Static Compliance ml/cm H20 ACE % Metabolism Time High Vt Low Vt High Vt Low Vt Baseline 4.0±0.6‡ 3.1±0.6 77.9±7.1 75.Ü40 1 Hour 3.6±0.6‡ 2.7±0.4 2 Hoars 3.5±0.6‡ 2.5±0.4 62.1± 11.8† 69.9±2.2† 3 Hoars 3.2±0.4†‡ Z4±0.3 4 Hoars 3.1±0.7†‡ 2.4±OJ‡ 51.7±3†‡ 66.3±3.0† 5 Hoars 3.140.5†‡ 2.7±0.4 † different from baseline, ‡ diffraent from Low Vt p < 0.05 Conclusion: Despite the lower initial static oompüance m the low V, group, this strategy resulted in more stable long compliances and preatrwd better cnrinthrlial functions than a higher V, low PEEP strategy in a PMA-indoced rabbit ALI model Speculation: Minimizing "votatraama" in AU presents not only louintory fimctions of the tang, but may also preserve vital tun-respiratory fonctions.
|Original language||English (US)|
|Journal||Critical care medicine|
|Issue number||1 SUPPL.|
|State||Published - Dec 1 1998|
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine