Effects of descending positive end-expiratory pressure on lung mechanics and aeration in healthy anaesthetized piglets

Detalhes bibliográficos
Autor(a) principal: Carvalho, Alysson Roncally S.
Data de Publicação: 2006
Outros Autores: Jandre, Frederico C., Pino, Alexandre V., Bozza, Fernando A., Salluh, Jorge I., Rodrigues, Rosana S., Soares, João H. N., Giannella-Neto, Antonio
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/57307
Resumo: ARSC, FCJ, FAB, JHNS and JS performed the experiments. ARSC participated in the design of the study, performed the statistical analysis and wrote the manuscript. FCJ participated in the design of the study, discussed the results and revised the manuscript. AVP designed the experimental setup. FAB and JS participated in the design of the study and discussed the results. RR established the CT protocol and analysis. JHNS discussed the results. AG-N conceived and coordinated the study and helped to write the manuscript. All authors read and approved the final manuscript.
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spelling Carvalho, Alysson Roncally S.Jandre, Frederico C.Pino, Alexandre V.Bozza, Fernando A.Salluh, Jorge I.Rodrigues, Rosana S.Soares, João H. N.Giannella-Neto, Antonio2023-03-09T01:02:44Z2023-03-09T01:02:44Z2006CARVALHO, Alysson Roncally S. et al. Effects of descending positive end-expiratory pressure on lung mechanics and aeration in healthy anaesthetized piglets. Critical Care, London, v. 10, n. 4, p. 1-8, 2006.1364-8535https://www.arca.fiocruz.br/handle/icict/5730710.1186/cc50301466-609XARSC, FCJ, FAB, JHNS and JS performed the experiments. ARSC participated in the design of the study, performed the statistical analysis and wrote the manuscript. FCJ participated in the design of the study, discussed the results and revised the manuscript. AVP designed the experimental setup. FAB and JS participated in the design of the study and discussed the results. RR established the CT protocol and analysis. JHNS discussed the results. AG-N conceived and coordinated the study and helped to write the manuscript. All authors read and approved the final manuscript.Fabio Ascoli MSc (FIOCRUZ, Rio de Janeiro, RJ, Brazil) helped during the anaesthetic procedure. This work was partly supported by the Brazilian Agencies CNPq and FAPERJ.Federal University of Rio de Janeiro. COPPE. Biomedical Engineering Program. Rio de Janeiro, RJ, Brazil.Federal University of Rio de Janeiro. COPPE. Biomedical Engineering Program. Rio de Janeiro, RJ, Brazil.Catholic University of Pelotas. Electronic Engineering Department. Pelotas, RS, Brazil.Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brazil / Federal University of Rio de Janeiro. Clementino Fraga Filho Hospital. Rio de Janeiro, RJ, Brazil.National Institute of Cancer. Rio de Janeiro, RJ, Brazil.Federal University of Rio de Janeiro. Clementino Fraga Filho Hospital. Radiodiagnostic Service. Rio de Janeiro, RJ, Brazil.UNIGRANRIO University. School of Veterinary Medicine. Duque de Caxias, RJ, Brazil.Federal University of Rio de Janeiro. COPPE. Biomedical Engineering Program. Rio de Janeiro, RJ, Brazil.Introduction: Atelectasis and distal airway closure are common clinical entities of general anaesthesia. These two phenomena are expected to reduce the ventilation of dependent lung regions and represent major causes of arterial oxygenation impairment in anaesthetic conditions. In the present study, the behavior of the elastance of the respiratory system (Ers), as well as the lung aeration assessed by CT-scan, was evaluated during a descendent positive end-expiratory pressure (PEEP) titration. This work sought to evaluate the potential usefulness of the Ers monitoring to set the PEEP in order to prevent tidal recruitment and hyperinflation of healthy lungs under general anaesthesia. Methods: PEEP titration (from 16 to 0 cmH2O, with a tidal volume of 8 ml/kg) was performed, and at each PEEP, helical CT-scans were obtained during end-expiratory and end-inspiratory pauses in six healthy, anaesthetized and paralyzed piglets. The distribution of lung compartments (hyperinflated (HA), normally- (NA), poorly- (PA), and non-aerated areas (N)) was determined and the tidal re-aeration was calculated as the difference between end-expiratory and end-inspiratory PA and NA areas. Similarly, the tidal hyperinflation was obtained as the difference between end-inspiratory and end-expiratory HA. The Ers was estimated on a breath-by-breath basis from the equation of motion of the respiratory system during all PEEP titration with the least squares method. Results: HA decreased throughout PEEP descent from PEEP 16 cmH2O to ZEEP (ranges from 24-62% to 1-7% at end-expiratory and from 44-73% to 4-17% at end-inspiratory pauses) whereas NA areas increased (30-66% to 72-83% at end-expiratory and from 19-48% to 73-77% at end-inspiratory pauses). From 16 to 8 cmH2O, Ers decreased with a correspondent reduction in tidal hyperinflation. A flat minimum of Ers was observed from 8 to 4 cmH2O. For PEEP below 4 cmH2O, Ers increased associated with a rise in tidal re-aeration and a flat maximum of the NA areas. Conclusion: In healthy piglets under a descending PEEP protocol, the PEEP at minimum Ers presented a compromise between maximizing NA areas and minimizing tidal re-aeration and hyperinflation. High levels of PEEP, greater than 8 cmH2O, reduced tidal re-aeration but enlarged hyperinflation with a concomitant decrease in normally aerated areas.engBMCEffects of descending positive end-expiratory pressure on lung mechanics and aeration in healthy anaesthetized pigletsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleEnd-expiratory pressure (PEEP)Lung mechanicsinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZORIGINALve_Carvalho_Alysson_etal_INI_2006.pdfve_Carvalho_Alysson_etal_INI_2006.pdfapplication/pdf627725https://www.arca.fiocruz.br/bitstream/icict/57307/2/ve_Carvalho_Alysson_etal_INI_2006.pdfa91ea0bf72d68b35cf8a5e01f5eeff46MD52LICENSElicense.txttext/plain1748https://www.arca.fiocruz.br/bitstream/icict/57307/1/license.txt8a4605be74aa9ea9d79846c1fba20a33MD51icict/573072023-03-08 22:26:16.862oai:www.arca.fiocruz.br:icict/57307Tk9URTogUExBQ0UgWU9VUiBPV04gTElDRU5TRSBIRVJFClRoaXMgc2FtcGxlIGxpY2Vuc2UgaXMgcHJvdmlkZWQgZm9yIGluZm9ybWF0aW9uYWwgcHVycG9zZXMgb25seS4KCk5PTi1FWENMVVNJVkUgRElTVFJJQlVUSU9OIExJQ0VOU0UKCkJ5IHNpZ25pbmcgYW5kIHN1Ym1pdHRpbmcgdGhpcyBsaWNlbnNlLCB5b3UgKHRoZSBhdXRob3Iocykgb3IgY29weXJpZ2h0Cm93bmVyKSBncmFudHMgdG8gRFNwYWNlIFVuaXZlcnNpdHkgKERTVSkgdGhlIG5vbi1leGNsdXNpdmUgcmlnaHQgdG8gcmVwcm9kdWNlLAp0cmFuc2xhdGUgKGFzIGRlZmluZWQgYmVsb3cpLCBhbmQvb3IgZGlzdHJpYnV0ZSB5b3VyIHN1Ym1pc3Npb24gKGluY2x1ZGluZwp0aGUgYWJzdHJhY3QpIHdvcmxkd2lkZSBpbiBwcmludCBhbmQgZWxlY3Ryb25pYyBmb3JtYXQgYW5kIGluIGFueSBtZWRpdW0sCmluY2x1ZGluZyBidXQgbm90IGxpbWl0ZWQgdG8gYXVkaW8gb3IgdmlkZW8uCgpZb3UgYWdyZWUgdGhhdCBEU1UgbWF5LCB3aXRob3V0IGNoYW5naW5nIHRoZSBjb250ZW50LCB0cmFuc2xhdGUgdGhlCnN1Ym1pc3Npb24gdG8gYW55IG1lZGl1bSBvciBmb3JtYXQgZm9yIHRoZSBwdXJwb3NlIG9mIHByZXNlcnZhdGlvbi4KCllvdSBhbHNvIGFncmVlIHRoYXQgRFNVIG1heSBrZWVwIG1vcmUgdGhhbiBvbmUgY29weSBvZiB0aGlzIHN1Ym1pc3Npb24gZm9yCnB1cnBvc2VzIG9mIHNlY3VyaXR5LCBiYWNrLXVwIGFuZCBwcmVzZXJ2YXRpb24uCgpZb3UgcmVwcmVzZW50IHRoYXQgdGhlIHN1Ym1pc3Npb24gaXMgeW91ciBvcmlnaW5hbCB3b3JrLCBhbmQgdGhhdCB5b3UgaGF2ZQp0aGUgcmlnaHQgdG8gZ3JhbnQgdGhlIHJpZ2h0cyBjb250YWluZWQgaW4gdGhpcyBsaWNlbnNlLiBZb3UgYWxzbyByZXByZXNlbnQKdGhhdCB5b3VyIHN1Ym1pc3Npb24gZG9lcyBub3QsIHRvIHRoZSBiZXN0IG9mIHlvdXIga25vd2xlZGdlLCBpbmZyaW5nZSB1cG9uCmFueW9uZSdzIGNvcHlyaWdodC4KCklmIHRoZSBzdWJtaXNzaW9uIGNvbnRhaW5zIG1hdGVyaWFsIGZvciB3aGljaCB5b3UgZG8gbm90IGhvbGQgY29weXJpZ2h0LAp5b3UgcmVwcmVzZW50IHRoYXQgeW91IGhhdmUgb2J0YWluZWQgdGhlIHVucmVzdHJpY3RlZCBwZXJtaXNzaW9uIG9mIHRoZQpjb3B5cmlnaHQgb3duZXIgdG8gZ3JhbnQgRFNVIHRoZSByaWdodHMgcmVxdWlyZWQgYnkgdGhpcyBsaWNlbnNlLCBhbmQgdGhhdApzdWNoIHRoaXJkLXBhcnR5IG93bmVkIG1hdGVyaWFsIGlzIGNsZWFybHkgaWRlbnRpZmllZCBhbmQgYWNrbm93bGVkZ2VkCndpdGhpbiB0aGUgdGV4dCBvciBjb250ZW50IG9mIHRoZSBzdWJtaXNzaW9uLgoKSUYgVEhFIFNVQk1JU1NJT04gSVMgQkFTRUQgVVBPTiBXT1JLIFRIQVQgSEFTIEJFRU4gU1BPTlNPUkVEIE9SIFNVUFBPUlRFRApCWSBBTiBBR0VOQ1kgT1IgT1JHQU5JWkFUSU9OIE9USEVSIFRIQU4gRFNVLCBZT1UgUkVQUkVTRU5UIFRIQVQgWU9VIEhBVkUKRlVMRklMTEVEIEFOWSBSSUdIVCBPRiBSRVZJRVcgT1IgT1RIRVIgT0JMSUdBVElPTlMgUkVRVUlSRUQgQlkgU1VDSApDT05UUkFDVCBPUiBBR1JFRU1FTlQuCgpEU1Ugd2lsbCBjbGVhcmx5IGlkZW50aWZ5IHlvdXIgbmFtZShzKSBhcyB0aGUgYXV0aG9yKHMpIG9yIG93bmVyKHMpIG9mIHRoZQpzdWJtaXNzaW9uLCBhbmQgd2lsbCBub3QgbWFrZSBhbnkgYWx0ZXJhdGlvbiwgb3RoZXIgdGhhbiBhcyBhbGxvd2VkIGJ5IHRoaXMKbGljZW5zZSwgdG8geW91ciBzdWJtaXNzaW9uLgo=Repositório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352023-03-09T01:26:16Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)false
dc.title.en_US.fl_str_mv Effects of descending positive end-expiratory pressure on lung mechanics and aeration in healthy anaesthetized piglets
title Effects of descending positive end-expiratory pressure on lung mechanics and aeration in healthy anaesthetized piglets
spellingShingle Effects of descending positive end-expiratory pressure on lung mechanics and aeration in healthy anaesthetized piglets
Carvalho, Alysson Roncally S.
End-expiratory pressure (PEEP)
Lung mechanics
title_short Effects of descending positive end-expiratory pressure on lung mechanics and aeration in healthy anaesthetized piglets
title_full Effects of descending positive end-expiratory pressure on lung mechanics and aeration in healthy anaesthetized piglets
title_fullStr Effects of descending positive end-expiratory pressure on lung mechanics and aeration in healthy anaesthetized piglets
title_full_unstemmed Effects of descending positive end-expiratory pressure on lung mechanics and aeration in healthy anaesthetized piglets
title_sort Effects of descending positive end-expiratory pressure on lung mechanics and aeration in healthy anaesthetized piglets
author Carvalho, Alysson Roncally S.
author_facet Carvalho, Alysson Roncally S.
Jandre, Frederico C.
Pino, Alexandre V.
Bozza, Fernando A.
Salluh, Jorge I.
Rodrigues, Rosana S.
Soares, João H. N.
Giannella-Neto, Antonio
author_role author
author2 Jandre, Frederico C.
Pino, Alexandre V.
Bozza, Fernando A.
Salluh, Jorge I.
Rodrigues, Rosana S.
Soares, João H. N.
Giannella-Neto, Antonio
author2_role author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Carvalho, Alysson Roncally S.
Jandre, Frederico C.
Pino, Alexandre V.
Bozza, Fernando A.
Salluh, Jorge I.
Rodrigues, Rosana S.
Soares, João H. N.
Giannella-Neto, Antonio
dc.subject.en.en_US.fl_str_mv End-expiratory pressure (PEEP)
Lung mechanics
topic End-expiratory pressure (PEEP)
Lung mechanics
description ARSC, FCJ, FAB, JHNS and JS performed the experiments. ARSC participated in the design of the study, performed the statistical analysis and wrote the manuscript. FCJ participated in the design of the study, discussed the results and revised the manuscript. AVP designed the experimental setup. FAB and JS participated in the design of the study and discussed the results. RR established the CT protocol and analysis. JHNS discussed the results. AG-N conceived and coordinated the study and helped to write the manuscript. All authors read and approved the final manuscript.
publishDate 2006
dc.date.issued.fl_str_mv 2006
dc.date.accessioned.fl_str_mv 2023-03-09T01:02:44Z
dc.date.available.fl_str_mv 2023-03-09T01:02:44Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv CARVALHO, Alysson Roncally S. et al. Effects of descending positive end-expiratory pressure on lung mechanics and aeration in healthy anaesthetized piglets. Critical Care, London, v. 10, n. 4, p. 1-8, 2006.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/57307
dc.identifier.issn.en_US.fl_str_mv 1364-8535
dc.identifier.doi.none.fl_str_mv 10.1186/cc5030
dc.identifier.eissn.none.fl_str_mv 1466-609X
identifier_str_mv CARVALHO, Alysson Roncally S. et al. Effects of descending positive end-expiratory pressure on lung mechanics and aeration in healthy anaesthetized piglets. Critical Care, London, v. 10, n. 4, p. 1-8, 2006.
1364-8535
10.1186/cc5030
1466-609X
url https://www.arca.fiocruz.br/handle/icict/57307
dc.language.iso.fl_str_mv eng
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dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
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dc.publisher.none.fl_str_mv BMC
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dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
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reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
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