OBJECTIVE To evaluate the impact of 2 tidal volumes (Ts) with or without positive end-expiratory pressure (PEEP) on lung mechanics, aeration, and gas exchange in healthy anesthetized dogs. ANIMALS 40 mixed-breed dogs with healthy lungs. PROCEDURES Anesthetized dogs were randomly assigned to 4 groups (n = 10/group) with different ventilatory settings: T of 8 mL/kg and PEEP of 0 cm HO (low T group), T of 8 mL/kg and PEEP of 5 cm HO (low T plus PEEP group), T of 15 mL/kg and PEEP of 0 cm HO (high T group), or T of 15 mL/kg and PEEP of 5 cm HO (high T plus PEEP group). Expired CO and respiratory rate were titrated on the basis of a predetermined stepwise protocol. Gas exchange, respiratory mechanics, and pulmonary aeration were evaluated by means of CT 30 minutes after starting mechanical ventilation at the assigned setting. RESULTS Partial pressures of arterial and expired CO were higher in the low T and low T plus PEEP groups than in the high T and high T plus PEEP groups. Peak and plateau airway pressures were higher in the PEEP group than in the other groups. Static lung compliance was higher in the high T plus PEEP group than in the low T group. Relative percentages of atelectatic and poorly aerated lung were lower in the high T plus PEEP group than in the other groups. Oxygenation was similar among groups. CONCLUSIONS AND CLINICAL RELEVANCE Differences in T and PEEP application during mechanical ventilation may affect respiratory function in anesthetized dogs with healthy lungs. Ventilation with a T of 15 mL/kg and PEEP of 5 cm HO significantly improved lung compliance and reduced the amount of atelectatic and poorly aerated lung.
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http://dx.doi.org/10.2460/ajvr.79.5.496 | DOI Listing |
Ann Ital Chir
December 2024
Department of Anesthesiology, Institute of Anesthesia, Emergency and Critical Care, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, 225002 Yangzhou, Jiangsu, China.
Aim: Intraoperative lung-protective ventilation strategies (LPVS) have been shown to improve lung oxygenation and prevent postoperative pulmonary problems in surgical patients. However, the application of positive end-expiratory pressure (PEEP)-based LPVS in emergency traumatic brain injury (TBI) has not been thoroughly explored. The purpose of this study is to evaluate the effects of drive pressure-guided individualized PEEP on perioperative pulmonary oxygenation, postoperative pulmonary complications, and recovery from neurological injury in patients with TBI.
View Article and Find Full Text PDFIntensive Care Med Exp
December 2024
Department of Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.
High intrapulmonary pressures, large tidal volumes, and elevated respiratory rates during controlled mechanical ventilation can lead to barotrauma, volutrauma, and atelectrauma. Mechanical power-defined as the product of the pressure-volume integral and respiratory rate-consolidates these three risk factors into a single, intuitive parameter. Several studies have demonstrated that higher mechanical power correlates with an increased risk of lung injury and mortality, prompting the suggestion that mechanical power should be minimized.
View Article and Find Full Text PDFSci Rep
December 2024
Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, via Trontro 10/a, 60126, Ancona, Italy.
Mechanical ventilation with high tidal volume (TV) or positive end-expiratory pressure (PEEP) may induce lung overinflation and increased pulmonary vascular resistance to flow. In 8 healthy mechanically ventilated pigs, we evaluated whether incident dark field (IDF) vital microscopy, applied through a small thoracotomy, could be used to evaluate changes in alveolar and pulmonary microvessel dimensions under different ventilator settings. High TV (12 ml/kg) increased alveolar diameters (from 99 ± 13 to 114 ± 6 μm, p < 0.
View Article and Find Full Text PDFIntensive Care Med Exp
November 2024
Critical Care Research Group, The Prince Charles Hospital, Level 3, Clinical Sciences Building, Chermside Qld 4032, Brisbane, QLD, Australia.
Braz J Anesthesiol
November 2024
Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Programa de Pós-Graduação em Ciências Pneumológicas, Porto Alegre, RS, Brasil; Hospital de Clinicas de Porto Alegre (HCPA), Porto Alegre, RS, Brasil.
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