Small-dose perfluorocarbon reduces the recruitment pressure needed to open surfactant-deficient atelectatic lungs
Background: This study was undertaken to investigate the effect of a small dose of perfluorocarbon on the recruitment pressure needed to open atelectatic lung areas. Methods: In 12 Yorkshire pigs (body weight, 9 kg), lung injury was induced by whole lung lavage. After 1 h of conventional ventilation, an open lung maneuver was performed to obtain P ao 2 values equal to the pre-lavage P ao 2 values (±10%). After 1 h of ventilation at the lowest possible airway pressure that stabilized the recruited lung volume, the animals were disconnected from the ventilator to allow the lung to collapse. Six animals received a 5 ml/kg intratracheal dose of perfluorocarbon and a second open lung maneuver was performed. Six animals served as controls and received no perfluorocarbon but also underwent a second open lung maneuver. Results: In both groups, an open lung maneuver resulted in a significant increase in oxygenation. The peak pressures needed to open the lung after 1 h of mechanical ventilation in the perfluorocarbon and control groups were 43.8 ± 8.4 cmH 2O and 46.6 ± 4 cmH 2O, respectively. The addition of perfluorocarbon significantly reduced the opening pressure to 34.5 ± 6.3 cmH 2O (P < 0.01), whereas the opening pressure in the control group, 45.0 ± 0.2 cmH 2O, did not change. Conclusion: The instillation of a small amount of perfluorocarbon significantly reduces the opening pressures needed to recruit atelectatic lung areas.
|Keywords||ARDS, Auto-PEEP, Fluorocarbons, Protective ventilation, Recruitment maneuvers, Ventilator-induced lung injury|
|Persistent URL||dx.doi.org/10.1111/j.1399-6576.2006.001007.x, hdl.handle.net/1765/73862|
|Journal||Acta Anaesthesiologica Scandinavica: an international journal of anaesthesiology and intensive care, pain and emergency medicine|
Houmes, R.J.M, Lachmann, R.A, Haitsma, J.J, & Lachmann, B.F. (2006). Small-dose perfluorocarbon reduces the recruitment pressure needed to open surfactant-deficient atelectatic lungs. Acta Anaesthesiologica Scandinavica: an international journal of anaesthesiology and intensive care, pain and emergency medicine, 50(5), 586–592. doi:10.1111/j.1399-6576.2006.001007.x