1991
DOI: 10.1164/ajrccm/143.5_pt_1.1115
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Histopathologic Pulmonary Changes from Mechanical Ventilation at High Peak Airway Pressures

Abstract: We investigated the histopathologic pulmonary changes induced by mechanical pulmonary ventilation (MV) with a high peak airway pressure and a large tidal volume in healthy baby pigs. Eleven animals were mechanically ventilated at a peak inspiratory pressure (PIP) of 40 cm H2O, a respiratory rate (RR) of 20 min-1, a positive end-expiratory pressure (PEEP) of 3 to 5 cm H2O, and an FIO2 of 0.4. High airway pressure MV was terminated in 22 +/- 11 h because of severe hypoxemia in the animals. Five of the baby pigs … Show more

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Cited by 298 publications
(133 citation statements)
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“…Body temperature was maintained at 36.5-38.0 1C, anesthesia and supplemental fluids were administered intravenously for the requirement throughout the experiment. Mechanical ventilation was initiated in the pressure-controlled mode (Kent Scientific Ventilator-Dual Mode, USA) with a peak inspiratory pressure (PIP) of 15 cmH 2 O, a positive endexpiratory pressure (PEEP) of 2 cm H 2 O, a frequency of 30 breaths/min to maintain PaCO 2 at 35-45 mm Hg, an inspiration-to-expiration (I:E) ratio of 1:2, and an inhaled oxygen fraction (FiO 2 ) of 0.7 for 15 min, after which the baseline data were collected and the animals were randomly allocated to three ventilation strategies, each for 4 h, the groups were described as follows: (1 2 and O 2 were tested using a gas monitor (DATEX Instrumentarium, Helsinki, Finland).…”
Section: Experimental Protocolmentioning
confidence: 99%
See 1 more Smart Citation
“…Body temperature was maintained at 36.5-38.0 1C, anesthesia and supplemental fluids were administered intravenously for the requirement throughout the experiment. Mechanical ventilation was initiated in the pressure-controlled mode (Kent Scientific Ventilator-Dual Mode, USA) with a peak inspiratory pressure (PIP) of 15 cmH 2 O, a positive endexpiratory pressure (PEEP) of 2 cm H 2 O, a frequency of 30 breaths/min to maintain PaCO 2 at 35-45 mm Hg, an inspiration-to-expiration (I:E) ratio of 1:2, and an inhaled oxygen fraction (FiO 2 ) of 0.7 for 15 min, after which the baseline data were collected and the animals were randomly allocated to three ventilation strategies, each for 4 h, the groups were described as follows: (1 2 and O 2 were tested using a gas monitor (DATEX Instrumentarium, Helsinki, Finland).…”
Section: Experimental Protocolmentioning
confidence: 99%
“…1,2 The primarily biological mechanisms include the release of inflammatory mediators and oxygen radicals, leading to end-organ epithelial cell apoptosis and organ dysfunction. [3][4][5] In a previous study, a high tidal volume in mouse lung could induce the activation of c-Jun N-terminal kinase (JNK), an increase in macrophage inflammatory protein-2 (MIP-2) expression, and the migration of neutrophil into the lung.…”
Section: Introductionmentioning
confidence: 99%
“…These results make intuitive sense, and there are some data in the literature to support this interpretation. Animal ventilator studies indicate with regularity that the blood-gas barrier begins to break down, as indicated by edema formation, histopathological changes, and impaired lung mechanics, only when peak transpulmonary pressures exceed 25-30 cmH 2 O (6,14,37,47,48). In rabbit lungs fixed in situ after exposure to high transmural pressure, epithelial ''breaks'' were markedly increased when inflation pressure was elevated from 5 to 20 cmH 2 O (23).…”
Section: Deformation-induced Injury Of Alveolar Epithelial Cellsmentioning
confidence: 99%
“…As the mortality rate of ARDS continues to decline, the demonstration of improved survival from any single therapeutic modality will prove more difficult, requiring studies with large numbers of patients in well designed multicentre trials, and probably added reliance on meta-analyses to identify their success or failure. Mechanical ventilation: In the past decade, barotrauma has moved to the forefront of the complications of mechanical ventilation, possibly being "worse than the disease" according to some authors (75)(76)(77)(78). In trying to move the understanding of this problem from bench to bedside, numerous investigators have ascertained that lung damage by barotrauma occurs in several animal models, and they have attempted to translate this into decreased morbidity and mortality in ARDS patients using a variety of 'lung protective' strategies (75)(76)(77)(78).…”
Section: Therapeutic Modalities In Ards: Reachingmentioning
confidence: 99%