tailieunhanh - Báo cáo y học: " Alveolar fluid clearance in healthy pigs and influence of positive end-expiratory pressure"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Alveolar fluid clearance in healthy pigs and influence of positive end-expiratory pressure. | García-Delgado et al. Critical Care 2010 14 R36 http content 14 2 R36 c CRITICAL CARE RESEARCH Open Access Alveolar fluid clearance in healthy pigs and influence of positive end-expiratory pressure Manuel García-Delgado1 Ángel Touma-Fernández2 Virginia Chamorro-Marín3 Antonio Ruiz-Aguilar1 Eduardo Aguilar-Alonso1 Enrique Fernández-Mondéjar1 Abstract Introduction The objectives were to characterize alveolar fluid clearance AFC in pigs with normal lungs and to analyze the effect of immediate application of positive end-expiratory pressure PEEP . Methods Animals n 25 were mechanically ventilated and divided into four groups small edema SE group producing pulmonary edema PE by intratracheal instillation of 4 ml kg of saline solution small edema with PEEP SE PEEP group same as previous but applying PEEP of 10 cmH2O large edema LE group producing PE by instillation of 10 ml kg of saline solution and large edema with PEEP LE PEEP group same as LE group but applying PEEP of 10 cmH2O. AFC was estimated from differences in extravascular lung water values obtained by transpulmonary thermodilution method. Results At one hour AFC was in SE group and in LE group. In the SE PEEP group the AFC rate was higher at one hour than at subsequent time points and higher than in the SE group vs. at one hour P . The AFC rate was also significantly higher in the LE PEEP than in the LE group at three hours and four hours. Conclusions In this pig model the AFC rate is around 20 at one hour and around 50 at four hours regardless of the amount of edema and is increased by the application of PEEP. Introduction Resorption of alveolar fluid is the key to resolving pulmonary edema and considerable research efforts have focused in recent years on the mechanisms that underlie alveolar clearance 1-3 . Active ion transport is the main mechanism involved in the removal of fluid from distal air spaces of the intact lung. Other catecholaminergic and .