The effects of positive end-expiratory pressure in alveolar recruitment during mechanical ventilation in pigs

Mädke, Gabriel Ribeiro; Pilla, Eduardo Sperb; Sanchez, Pablo Geraldo; Foernges, Rafael Botelho; Grün, Gustavo; Vendrami, Giovani; Fontena, Eduardo; Andrade, Cristiano Feijó; Cardoso, Paulo Francisco Guerreiro

doi:10.1590/s0102-86502008000400003

Cited by 3 publications

(2 citation statements)

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“…8,16 In the present study, we used 2 different levels of PEEP after unilateral lung transplant in pigs and demonstrated that mechanical ventilation with higher PEEP levels (10 cm H 2 O) using a pressure-controlled mode increased lung compliance and reduced airway resistance (Table 1). Higher PEEP was not associated with better oxygenation in pigs after unilateral lung transplant (Table 1).…”

Section: Discussionmentioning

confidence: 59%

“…17,18 The present ventilatory findings were consistent with those from previous studies that evaluated the effects of increasing levels of PEEP at constant tidal volume, which resulted in higher compliance and lower resistance. 16 Experimental and clinical studies have shown that protective ventilatory strategies and open-lung strategies may affect the progression of lung injury. [19][20][21][22] The present histologic findings included severe acute lung injury in both groups after transplant and at the end of the observation period.…”

Section: Discussionmentioning

confidence: 99%

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Effect of Positive End-Expiratory Pressure After Porcine Unilateral Left Lung Transplant

Mädke

Forgiarini²,

Grün³

et al. 2012

Exp Clin Transplant

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Objectives: To evaluate the effects of 2 different levels of positive end-expiratory pressure on pigs who had unilateral lung transplants. Materials and Methods: A left lung transplant was performed in 12 pigs. The animals were randomized into 2 groups based on positive end-expiratory pressure: group 1 (5 cm H 2 O) and group 2 (10 cm H 2 O). Hemodynamics, gas exchange, and respiratory mechanics were measured before and after surgery. Cytokines, oxidative stress, and histologic scores were assessed in the lung tissue of each pig. Results: Pigs in group 2 exhibited a significantly higher mean heart rate (P = .006), static compliance (P = .001), lower mean arterial pressure (P = .003), and airway resistance (P = .001) than did pigs in group 1. There were no postoperative differences between the groups in concentrations of thiobarbituric acid reactive substances, superoxide dismutase, and interleukin 8. At the end of the observation period, pigs in group 2 had higher levels of thiobarbituric acid reactive substances (P = .001) and interleukin 8 (P = .05), and pigs in group 1 had higher levels of superoxide dismutase (P = .05) than they did at baseline. Conclusions: After unilateral lung transplant, higher positive end-expiratory pressure was associated with improved respiratory mechanics, a negative effect on hemodynamics, a stronger inflammatory response, and increased production of reactive oxygen species, but no effect on gas exchange.

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Section: Discussionmentioning

confidence: 59%