Effekte wiederholter Erstellung der pulmonalen Druck-Volumen-Kurve auf Gasaustausch und Hämodynamik beim experimentellen Lungenversagen

The present experimental animal study on eight female pigs investigated the effects of the repeated construction of the Pressure-Volume Curve in acutely injured lungs, exemplary here in an experimentally induced ARDS. For this investigation we used a built-in tool in a commercially available ventilator to construct a PV-curve. Acute lung injury was induced by repeated lung lavage with 0,9% NaCl solution. Acute lung injury was considered stable after a constant PaO2/FiO2 ratio below 100 mmHg for at least one hour. Ventilation was set to volume controlled mode with a PEEP of 10 cmH2O and I:E ratio of 1:1,5. The PV-maneuver was performed five times in series. Before and after each PV-curve construction hemodynamics, oxygenation and lung mechanic parameters were taken and CT scans were done. There was a continuous and significant reduction in VPEEP and VMAX from each PV-curve construction to the next (p 0.012). There was a significant decrease in PaO2 from 90,4+/-33,3 to 70,9+/-36,3 mmHg (p < 0,005), caused by a rise in venous admixture from 47,8+/-12,7 to 59,1+/-16,6 (p < 0,05). The CT scan-analysis showed no significant loss of total lung volume (VTOT). There was a loss of VAER (p 0,047), caused by a significant increase of VHYP (p 0,001) and VNON (p 0,037). There was a change in the distribution of ventilation too. After repeatedly generating the PV-curve there was an decrease of tidal ventilation in the aerated parenchyma, but an increase in tidal ventilation in hyperinflated (VHYP) and nonaerated parenchyma (VNGF and VNON). Because of these unexpected results which showed a loss of lung volume already after the first PV-cure construction the selection of the maneuver characteristics in the PV-Tool should be critically inspected, to get less adverse effects on the aerated parenchyma.

Grantor dc:publisher

Publikationsserver der RWTH Aachen University

Year dc:date

2009

Author dc:creator

• Waskowiak, Britta

Contributors dc:contributor

• Rossaint, Rolf

• info:eu-repo/classification/ddc/610
• ARDS
• Ventilation
• Medizin
• pulmonale Druck-Volumen-Kurve
• Atelektasen
• akutes Lungenversagen
• pulmonary Pressure-Volume Curve
• atelectasis
• Acute respiratory distress syndrome

Statement dc:rights

• info:eu-repo/semantics/openAccess

Language dc:language

ger

Identifier

https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-113290%22

OAI record oai:identifier

https://publications.rwth-aachen.de/oai2d?verb=GetRecord&metadataPrefix=oai_dc&identifier=oai%3Apublications.rwth-aachen.de%3A50761