+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Variable positive end-expiratory pressure can maintain oxygenation in experimental acute respiratory distress syndrome induced by oleic acid in dogs



Variable positive end-expiratory pressure can maintain oxygenation in experimental acute respiratory distress syndrome induced by oleic acid in dogs



Brazilian Journal of Medical and Biological Research 42(8): 731-737



The use of positive end-expiratory pressure (PEEP) or lung recruitment maneuvers (RM) to improve oxygenation in acute respiratory distress syndrome (ARDS) is used but it may reduce cardiac output (CO). Intermittent PEEP may avoid these complications. Our objective was to determine if variable PEEP compared with constant PEEP is capable of maintaining arterial oxygenation and minimizing hemodynamic alterations with or without RM. Eighteen dogs with ARDS induced by oleic acid were randomized into three equal groups: group 1, low variable PEEP; group 2, high variable PEEP, and group 3, RM + high variable PEEP. All groups were submitted to constant PEEP, followed by variable PEEP (PEEP was increased from 5 to 10 cmH(2)O in group 1, and from 5 to 18 cmH(2)O in the other two groups). PaO(2) was higher in group 3 (356.2 +/- 65.4 mmHg) than in group 1 (92.7 +/- 29.7 mmHg) and group 2 (228.5 +/- 72.4 mmHg), P < 0.05. PaO(2) was maintained during variable PEEP except in group 2 (318.5 +/- 82.9 at constant PEEP to 228.5 +/- 72.4 at variable PEEP). There was a reduction in CO in group 3 after RM (3.9 +/- 1.1 before to 2.7 +/- 0.5 L*min(-1)*(m(2))(-1) after; P < 0.05), but there was not any difference between constant and variable PEEP periods (2.7 +/- 0.5 and 2.4 +/- 0.7 L*min(-1)*(m(2))(-1); P > 0.05. Variable PEEP is able to maintain PaO(2) when performed in combination with RM in dogs with ARDS. After RM, CO was reduced and there was no relevant difference between the variable and constant PEEP periods.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 056847357

Download citation: RISBibTeXText

PMID: 19649399


Related references

Variable effect of positive end-expiratory pressure on oxygenation in patients with acute respiratory distress syndrome. Anesthesiology 108(1): 165; Author Reply 165-6, 2008

Variable effect of positive end-expiratory pressure on oxygenation in patients with acute respiratory distress syndrome - Reply. 2008

Biologically variable ventilation increases arterial oxygenation over that seen with positive end-expiratory pressure alone in a porcine model of acute respiratory distress syndrome. Critical Care Medicine 28(7): 2457-2464, 2000

The effects of positive end-expiratory pressure targeting optimal oxygenation on local gas distribution and inflammation in dogs with acute respiratory distress syndrome. Zhonghua Nei Ke Za Zhi 49(10): 859-864, 2010

Positive end expiratory pressure titrated by transpulmonary pressure improved oxygenation and respiratory mechanics in acute respiratory distress syndrome patients with intra-abdominal hypertension. Chinese Medical Journal 126(17): 3234-3239, 2013

Scintigraphy of albumin leak in oleic acid canine adult respiratory distress syndrome effect of positive end expiratory pressure. American Review of Respiratory Disease 121(4 Part 2): 196, 1980

Effects of positive end-expiratory pressure on lung recruited volume and oxygenation in patients with acute respiratory distress syndrome. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue 16(7): 399-402, 2004

Gastric intramucosal pH is stable during titration of positive end-expiratory pressure to improve oxygenation in acute respiratory distress syndrome. Critical Care 7(3): R17-R23, 2003

Oxygenation response to positive end-expiratory pressure predicts mortality in acute respiratory distress syndrome. A secondary analysis of the LOVS and ExPress trials. American Journal of Respiratory and Critical Care Medicine 190(1): 70-76, 2014

Comparative oxygenation methods in oleic acid injured dogs suctioned before and during positive end expiratory pressure. Federation Proceedings 39(3): ABSTRACT 4337, 1980

Best compliance during a decremental, but not incremental, positive end-expiratory pressure trial is related to open-lung positive end-expiratory pressure: a mathematical model of acute respiratory distress syndrome lungs. American Journal of Respiratory and Critical Care Medicine 163(1): 69-78, 2001

Influence of mechanical respiration with positive expiratory pressure on the development of pulmonary embolism induced by oleic acid. Experimental study in dogs. Amb 25(8): 279-287, 1979

Positive end-expiratory pressure-induced functional recruitment in patients with acute respiratory distress syndrome. Critical Care Medicine 38(1): 127-132, 2010

Evaluation of splanchnic perfusion and oxygenation during positive end-expiratory pressure ventilation in relation to subcutaneous tissue gases and pH. An experimental study in pigs with oleic acid-induced lung injury. European Surgical Research. Europaische Chirurgische Forschung. Recherches Chirurgicales Europeennes 33(3): 237-244, 2001