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Small‐dose perfluorocarbon reduces the recruitment pressure needed to open surfactant‐deficient atelectatic lungs
Author(s) -
Houmes R.J.,
Lachmann R. A.,
Haitsma J. J.,
Lachmann B.
Publication year - 2006
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.2006.001007.x
Subject(s) - medicine , lung , peak inspiratory pressure , anesthesia , mean airway pressure , oxygenation , airway , mechanical ventilation , ventilation (architecture) , lung volumes , atelectasis , pulmonary surfactant , respiratory system , tidal volume , anatomy , chemistry , mechanical engineering , engineering , biochemistry
Background: This study was undertaken to investigate the effect of a small dose of perfluorocarbon on the recruitment pressure needed to open atelectatic lung areas. Methods: In 12 Yorkshire pigs (body weight, 9 kg), lung injury was induced by whole lung lavage. After 1 h of conventional ventilation, an open lung maneuver was performed to obtain P a o 2 values equal to the pre‐lavage P a o 2 values (±10%). After 1 h of ventilation at the lowest possible airway pressure that stabilized the recruited lung volume, the animals were disconnected from the ventilator to allow the lung to collapse. Six animals received a 5 ml/kg intratracheal dose of perfluorocarbon and a second open lung maneuver was performed. Six animals served as controls and received no perfluorocarbon but also underwent a second open lung maneuver. Results: In both groups, an open lung maneuver resulted in a significant increase in oxygenation. The peak pressures needed to open the lung after 1 h of mechanical ventilation in the perfluorocarbon and control groups were 43.8 ± 8.4 cmH 2 O and 46.6 ± 4 cmH 2 O, respectively. The addition of perfluorocarbon significantly reduced the opening pressure to 34.5 ± 6.3 cmH 2 O ( P < 0.01), whereas the opening pressure in the control group, 45.0 ± 0.2 cmH 2 O, did not change. Conclusion: The instillation of a small amount of perfluorocarbon significantly reduces the opening pressures needed to recruit atelectatic lung areas.