Gas exchange and lung inflammation using nasal intermittent positive-pressure ventilation versus synchronized intermittent mandatory ventilation in piglets with saline lavage-induced lung injury: an observational study.
Crit Care Med
; 36(1): 183-7, 2008 Jan.
Article
en En
| MEDLINE
| ID: mdl-18090370
ABSTRACT
OBJECTIVE:
Physiologic and pathologic comparison of two modes of assisted ventilation, nasal intermittent positive-pressure ventilation (NIPPV) and synchronized intermittent mandatory ventilation (SIMV), in spontaneously breathing term newborn piglets with saline lavage-induced lung injury.DESIGN:
After inducing acute lung injury via repetitive saline lavage, piglets were randomized to NIPPV (n = 12) or SIMV (n = 11) and treated for 6 hrs.SETTING:
Clinical laboratory.SUBJECTS:
Spontaneously breathing term newborn piglets.INTERVENTIONS:
Invasive (SIMV) or noninvasive (NIPPV) assisted ventilation for 6 hrs. MEASUREMENTS Physiologic parameters and arterial blood gases were continuously monitored. At the conclusion of the study, lung tissue was obtained to analyze for evidence of inflammation, including myeloperoxidase, interleukin-8, and hydrogen peroxide levels, as well as for evidence of pathologic injury. MAINRESULTS:
Piglets treated with NIPPV demonstrated higher arterial blood gas pH (p < .001), lower PaCO2 (p < .05), and a lower set respiratory rate (p < .0001) as compared with the SIMV-treated piglets. The piglets in the SIMV group had higher PaO2/PaO2 ratio than those in the NIPPV group (p = .001). There was significantly more interstitial inflammation (p = .04) in the SIMV-treated piglets compared with the NIPPV-treated piglets. Total respiratory rate, heart rate, blood pressure, oxygen saturation, and biochemical markers of lung inflammation were not different between the groups.CONCLUSION:
In surfactant-deficient term newborn piglets, NIPPV offers an effective and noninvasive ventilatory strategy with the potential for less pathologic lung inflammation.
Buscar en Google
Base de datos:
MEDLINE
Asunto principal:
Neumonía
/
Síndrome de Dificultad Respiratoria
/
Intercambio Gaseoso Pulmonar
/
Ventilación con Presión Positiva Intermitente
Tipo de estudio:
Observational_studies
Límite:
Animals
Idioma:
En
Revista:
Crit Care Med
Año:
2008
Tipo del documento:
Article
País de afiliación:
Estados Unidos