ISSN:
1438-8359
Keywords:
Mechanical pulmonary ventilation
;
High peak inspiratory pressure
;
Acute respiratory failure
;
Barotrauma
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract The effects of high pressure mechanical pulmonary ventilation at a peak inspiratory pressure of 40 cmH2O were studied on the lungs of healthy newborn pigs (14–21 days after birth). Forty percent oxygen in nitrogen was used for ventilation to prevent oxygen intoxication. The control group (6 pigs) was ventilated for 48 hours at a peak inspiratory pressure less than 18 cmH2O and a PEEP of 3–5 cmH2O with a normal tidal volume, and a respiratory rate of 20 times/min. The control group showed few deleterious changes in the lungs for 48 hours. Eleven newborn pigs were ventilated at a peak inspiratory pressure of 40 cmH2O with a PEEP of 3–5 cmH2O and a respiratory rate of 20 times/min. To avoid respiratory alkalosis, a dead space was placed in the respiratory circuit, and normocarbia was maintained by adjusting dead space volume. In all cases in the latter group, severe pulmonary impairments, such as abnormal chest roentgenograms, hypoxemia, decreased total static lung compliance, high incidence of pneumothorax, congestive atelectasis, and increased lung weight were found within 48 hours of ventilation. When the pulmonary impairments became manifest, 6 of the 11 newborn pigs were switched to the conventional medical and ventilatory therapies for 3–6 days. However, all of them became ventilator dependent, and severe lung pathology was found at autopsy. These pulmonary insults by high pressure mechanical pulmonary ventilation could be occurring not infrequently in the respiratory management of patients with respiratory failure. (Tsuno K, Sakanashi Y, Kishi Y et al.: Acute respiratory failure induced by mechanical pulmonary ventilation at a peak inspiratory pressure of 40 cmH2O. J Anesth 2:176–183, 1988)
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/s0054080020176
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