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Effects of sustained pressure application on compliance and blood gases inhealthy porcine lungs
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
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2001 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 45, no 10, 1235-1240 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Short periods of sustained increase in airway pressures (Press(up)) are believed to re-open lung areas that collapsed upon induction of anaesthesia. Recruitment of alveolar surface is usually assessed in terms of changes in the pressure-volume (PV) curve. The purpose of this study was to analyse PV-curves before and after a Press(up) and to ascertain whether such changes are compatible with the concept of recruitment of lung volume.

METHODS:

During ketamine anaesthesia, 12 healthy piglets were subjected to a Press(up) with end-expiratory pressure (PEEP) of 12 cmH2O and end-inspiratory pressure of 40 cmH2O. Before and after Press(up), PV-curves were obtained from a slow insufflation of 630 ml at zero PEEP (ZEEP).

RESULTS:

Compliance was non-linear both before and after Press(up) increasing up to 300 ml and sharply decreasing thereafter. After Press(up), the entire compliance curve was shifted to a higher absolute level. Up to 100 ml and a pressure level corresponding to the lower inflection point on the PV-curve (LIP), compliance was higher before Press(up). No effects on blood gases could be observed.

CONCLUSION:

If the similar shape of the compliance curve corresponds to a similar chain of re-opening and overdistension events, this would imply that all volume gained by Press(up) is lost within 10 min, without explaining the higher absolute compliance following Press(up). We speculate that a) re-opening of rapidly collapsing small airways determines the initial compliance increase; b) the lower compliance after Press(up) until LIP indicates reduced intratidal re-opening of lung regions; and c) changes in bronchomotor tone induced by Press(up) raise the absolute compliance, with a similar scenario of alveolar and small airway recruitment now taking place but at different degrees of airway stiffness.

Place, publisher, year, edition, pages
2001. Vol. 45, no 10, 1235-1240 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-62911DOI: 10.1034/j.1399-6576.2001.451011.xPubMedID: 11736676OAI: oai:DiVA.org:uu-62911DiVA: diva2:90822
Available from: 2008-10-17 Created: 2008-10-17 Last updated: 2017-11-30Bibliographically approved

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Markström, AgnetaNordgren, AndersLichtwarck-Aschoff, Michael

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