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Effects of PEEP levels following repeated recruitment maneuvers on ventilator‐induced lung injury
Author(s) -
KO S.C.,
ZHANG H.,
HAITSMA J. J.,
CHENG K.C.,
LI C.F.,
SLUTSKY A. S.
Publication year - 2008
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.1399-6576.2008.01581.x
Subject(s) - medicine , positive end expiratory pressure , oxygenation , anesthesia , lung , pulmonary compliance , mechanical ventilation , tidal volume , respiratory physiology , ventilation (architecture) , respiratory system , physics , thermodynamics
Background: Different levels of positive end‐expiratory pressure (PEEP) with and without a recruitment maneuver (RM) may have a significant impact on ventilator‐induced lung injury but this issue has not been well addressed. Methods: Anesthetized rats received hydrochloric acid (HCl, pH 1.5) aspiration, followed by mechanical ventilation with a tidal volume of 6 ml/kg. The animals were randomized into four groups of 10 each: (1) high PEEP at 6 cm H 2 O with an RM by applying peak airway pressure at 30 cm H 2 O for 10 s every 15 min; (2) low PEEP at 2 cm H 2 O with RM; (3) high PEEP alone; and (4) low PEEP alone. Results: The mean arterial pressure and the amounts of fluid infused were similar in the four groups. Application of the higher PEEP improved oxygenation compared with the lower PEEP groups ( P <0.05). The lung compliance was better reserved, and the systemic cytokine responses and lung wet to dry ratio were lower in the high PEEP than in the low PEEP group for a given RM ( P <0.05). Conclusions: The use of a combination of periodic RM and the higher PEEP had an additive effect in improving oxygenation and pulmonary mechanics and attenuation of inflammation.