Variable ventilation enhances ventilation without exacerbating injury in preterm lambs with respiratory distress syndrome View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2012-10

AUTHORS

Clare A. Berry, Béla Suki, Graeme R. Polglase, J. Jane Pillow

ABSTRACT

BACKGROUND: As compared with constant respiratory rate (RR) and tidal volume (V(T)) during controlled conventional mechanical ventilation (CV), variable ventilation (VV) using the same breath-to-breath minute volume but variable V(T) and RRs enhances ventilation efficiency in preterm lambs. We hypothesized that if V(T) was adjusted to target permissive hypercarbia, VV would result in more efficient gas exchange without increasing inflammatory and injurious responses in the lung. METHODS: Preterm lambs at 129 d gestation were anesthetized, tracheotomized, and randomized to either CV (n = 8) or VV (n = 8) using the same initial average V(T) and RR. Lung mechanics and gas exchange were measured intermittently, and average V(T) was adjusted to target partial pressure of arterial carbon dioxide (PaCO2) of 40-50 mm Hg for 3 h. Lung injury and inflammation were assessed from bronchoalveolar lavage fluid, lung tissue, and peripheral blood. RESULTS: VV achieved permissive hypercarbia using a lower average V(T), peak inspiratory pressure, and elastance (increased compliance) as compared with CV. Oxygenation and markers of lung tissue inflammation or injury were not different apart from a lower wet:dry tissue ratio in the VV lungs. CONCLUSIONS: VV improves ventilation efficiency and in vivo lung compliance in the ovine preterm lung without increasing lung inflammation or lung injury. More... »

PAGES

384

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/pr.2012.97

DOI

http://dx.doi.org/10.1038/pr.2012.97

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1040546508

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/22805999


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