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

Author Lanza, Fernanda de Cordoba Autor UNIFESP Google Scholar
Damasceno, M.c.p. Autor UNIFESP Google Scholar
Leme, F. Autor UNIFESP Google Scholar
Yagui, Ana Cristina Zanon Autor UNIFESP Google Scholar
Paiva, K.c. Autor UNIFESP Google Scholar
Luque, A. Google Scholar
Beppu, Osvaldo Shigueomi Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Centro Universitário São Camilo
Universidade de São Paulo (USP)
Abstract 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 cmH2O in group 1, and from 5 to 18 cmH2O in the other two groups). PaO2 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. PaO2 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·(m2)-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·(m2)-1; P > 0.05. Variable PEEP is able to maintain PaO2 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.
Keywords Acute respiratory distress syndrome (ARDS)
PEEP
Mechanical ventilation
Oleic acid
Language English
Date 2009-08-01
Published in Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 42, n. 8, p. 731-737, 2009.
ISSN 0100-879X (Sherpa/Romeo, impact factor)
Publisher Associação Brasileira de Divulgação Científica
Extent 731-737
Origin http://dx.doi.org/10.1590/S0100-879X2009000800007
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000269123000007
SciELO ID S0100-879X2009000800007 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/5166

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