Immediate application of positive-end expiratory pressure is more effective than delayed positive-end expiratory pressure to reduce extravascular lung water
OBJECTIVEto determine by the measurement of extravascular lung water (EVLW) whether the timing of positive-end expiratory pressure (PEEP) application influences the intensity of lung injury. DESIGNAnimal experimental study. SETTINGAnimal experimental laboratory. SUBJECTSMixed-breed pigs (n = 18), ag...
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| Veröffentlicht in: | Critical care medicine 1999-02, Vol.27 (2), p.380-384 |
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| container_title | Critical care medicine |
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| creator | Ruiz-Bailen, Manuel Fernandez-Mondejar, Enrique Hurtado-Ruiz, Benjamin Colmenero-Ruiz, Manuel Rivera-Fernandez, Ricardo Guerrero-Lopez, Francisco Vazquez-Mata, Guillermo |
| description | OBJECTIVEto determine by the measurement of extravascular lung water (EVLW) whether the timing of positive-end expiratory pressure (PEEP) application influences the intensity of lung injury.
DESIGNAnimal experimental study.
SETTINGAnimal experimental laboratory.
SUBJECTSMixed-breed pigs (n = 18), aged 4 to 5 mos, weighing 25 to 30 kg.
INTERVENTIONSThe animals were anesthetized and tracheotomized, after which a permeability pulmonary edema was instigated by infusing oleic acid (0.1 /kg) into the central vein. All animals were then randomly divided into three groups. In group 1 (n = 5), 10 cm H2 O of PEEP was applied immediately after the oleic acid infusion and maintained throughout the 6 hrs of the experiment. Group 2 (n = 7) received the same level of PEEP 120 mins after the insult for 4 hrs. Group 3 (n = 6), the control group, was ventilated without PEEP for the six hrs of the experiment.
MEASUREMENTS AND MAIN RESULTSAt the end of the experiment, EVLW was calculated by gravimetric method. EVLW in group 1 (11.46 +/- 2.00 mL/kg) was significantly less than in group 2 (19.12 +/- 2.62 mL/kg) and group 3 (25.81 +/- 1.57 mL/kg), (p < .0001). Oxygenation also showed important differences by the end of the experiment when the PaO2/FIO2 ratio was significantly better in group 1 (467 +/- 73) than in group 2 (180 +/- 82) and group 3 (39 +/- 9), (p < .0001).
CONCLUSIONSThe application of 10 cm H2 O of PEEP reduces EVLW in a time-dependent manner and maximum protective effect is achieved if it is applied immediately after lung injury production. (Crit Care Med 1999; 27:380-384) |
| doi_str_mv | 10.1097/00003246-199902000-00046 |
| format | Article |
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DESIGNAnimal experimental study.
SETTINGAnimal experimental laboratory.
SUBJECTSMixed-breed pigs (n = 18), aged 4 to 5 mos, weighing 25 to 30 kg.
INTERVENTIONSThe animals were anesthetized and tracheotomized, after which a permeability pulmonary edema was instigated by infusing oleic acid (0.1 /kg) into the central vein. All animals were then randomly divided into three groups. In group 1 (n = 5), 10 cm H2 O of PEEP was applied immediately after the oleic acid infusion and maintained throughout the 6 hrs of the experiment. Group 2 (n = 7) received the same level of PEEP 120 mins after the insult for 4 hrs. Group 3 (n = 6), the control group, was ventilated without PEEP for the six hrs of the experiment.
MEASUREMENTS AND MAIN RESULTSAt the end of the experiment, EVLW was calculated by gravimetric method. EVLW in group 1 (11.46 +/- 2.00 mL/kg) was significantly less than in group 2 (19.12 +/- 2.62 mL/kg) and group 3 (25.81 +/- 1.57 mL/kg), (p < .0001). Oxygenation also showed important differences by the end of the experiment when the PaO2/FIO2 ratio was significantly better in group 1 (467 +/- 73) than in group 2 (180 +/- 82) and group 3 (39 +/- 9), (p < .0001).
CONCLUSIONSThe application of 10 cm H2 O of PEEP reduces EVLW in a time-dependent manner and maximum protective effect is achieved if it is applied immediately after lung injury production. (Crit Care Med 1999; 27:380-384)</description><identifier>ISSN: 0090-3493</identifier><identifier>EISSN: 1530-0293</identifier><identifier>DOI: 10.1097/00003246-199902000-00046</identifier><identifier>PMID: 10075064</identifier><identifier>CODEN: CCMDC7</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins, Inc</publisher><subject>Analysis of Variance ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Animals ; Biological and medical sciences ; Carbon Dioxide - blood ; Emergency and intensive respiratory care ; Extravascular Lung Water - chemistry ; Hemodynamics ; Intensive care medicine ; Medical sciences ; Oleic Acid ; Oxygen - blood ; Positive-Pressure Respiration ; Pulmonary Edema - blood ; Pulmonary Edema - chemically induced ; Pulmonary Edema - physiopathology ; Pulmonary Edema - therapy ; Random Allocation ; Swine ; Time Factors</subject><ispartof>Critical care medicine, 1999-02, Vol.27 (2), p.380-384</ispartof><rights>1999 Lippincott Williams & Wilkins, Inc.</rights><rights>1999 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3856-52e5603e797c54bd68ee0d839217a24e682bf15d657613d1d1d1734727d1e7af3</citedby><cites>FETCH-LOGICAL-c3856-52e5603e797c54bd68ee0d839217a24e682bf15d657613d1d1d1734727d1e7af3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1704948$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10075064$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ruiz-Bailen, Manuel</creatorcontrib><creatorcontrib>Fernandez-Mondejar, Enrique</creatorcontrib><creatorcontrib>Hurtado-Ruiz, Benjamin</creatorcontrib><creatorcontrib>Colmenero-Ruiz, Manuel</creatorcontrib><creatorcontrib>Rivera-Fernandez, Ricardo</creatorcontrib><creatorcontrib>Guerrero-Lopez, Francisco</creatorcontrib><creatorcontrib>Vazquez-Mata, Guillermo</creatorcontrib><title>Immediate application of positive-end expiratory pressure is more effective than delayed positive-end expiratory pressure to reduce extravascular lung water</title><title>Critical care medicine</title><addtitle>Crit Care Med</addtitle><description>OBJECTIVEto determine by the measurement of extravascular lung water (EVLW) whether the timing of positive-end expiratory pressure (PEEP) application influences the intensity of lung injury.
DESIGNAnimal experimental study.
SETTINGAnimal experimental laboratory.
SUBJECTSMixed-breed pigs (n = 18), aged 4 to 5 mos, weighing 25 to 30 kg.
INTERVENTIONSThe animals were anesthetized and tracheotomized, after which a permeability pulmonary edema was instigated by infusing oleic acid (0.1 /kg) into the central vein. All animals were then randomly divided into three groups. In group 1 (n = 5), 10 cm H2 O of PEEP was applied immediately after the oleic acid infusion and maintained throughout the 6 hrs of the experiment. Group 2 (n = 7) received the same level of PEEP 120 mins after the insult for 4 hrs. Group 3 (n = 6), the control group, was ventilated without PEEP for the six hrs of the experiment.
MEASUREMENTS AND MAIN RESULTSAt the end of the experiment, EVLW was calculated by gravimetric method. EVLW in group 1 (11.46 +/- 2.00 mL/kg) was significantly less than in group 2 (19.12 +/- 2.62 mL/kg) and group 3 (25.81 +/- 1.57 mL/kg), (p < .0001). Oxygenation also showed important differences by the end of the experiment when the PaO2/FIO2 ratio was significantly better in group 1 (467 +/- 73) than in group 2 (180 +/- 82) and group 3 (39 +/- 9), (p < .0001).
CONCLUSIONSThe application of 10 cm H2 O of PEEP reduces EVLW in a time-dependent manner and maximum protective effect is achieved if it is applied immediately after lung injury production. (Crit Care Med 1999; 27:380-384)</description><subject>Analysis of Variance</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Animals</subject><subject>Biological and medical sciences</subject><subject>Carbon Dioxide - blood</subject><subject>Emergency and intensive respiratory care</subject><subject>Extravascular Lung Water - chemistry</subject><subject>Hemodynamics</subject><subject>Intensive care medicine</subject><subject>Medical sciences</subject><subject>Oleic Acid</subject><subject>Oxygen - blood</subject><subject>Positive-Pressure Respiration</subject><subject>Pulmonary Edema - blood</subject><subject>Pulmonary Edema - chemically induced</subject><subject>Pulmonary Edema - physiopathology</subject><subject>Pulmonary Edema - therapy</subject><subject>Random Allocation</subject><subject>Swine</subject><subject>Time Factors</subject><issn>0090-3493</issn><issn>1530-0293</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkctOAyEUhonR2Fp9BcPC7SgMt2FpjJcmTdzoekKHMxalMxOYsfZdfFiprZeNEUJOSL7_hPOBEKbknBKtLkhaLOcyo1prkqdblg6Xe2hMBUuXXLN9NCZEk4xxzUboKMZnQigXih2iESVECSL5GL1Pl0uwzvSATdd5V5netQ1ua9y10fXuFTJoLIa3zgXTt2GNuwAxDgGwi3jZpgp1DdWGxP3CNNiCN2uw_-f7FgewQ5U6vPXBvJpYDd4E7IfmCa_Si8IxOqiNj3CyqxP0eHP9cHWXze5vp1eXs6xihZCZyEFIwkBpVQk-t7IAILZgOqfK5Bxkkc9rKqwUSlJm6WYrxlWuLAVlajZBxbZvFdoYA9RlF9zShHVJSbkRXn4JL7-Fl5_CU_R0G-2GeRL5K7g1nICzHZDmM74Opqlc_OEU4ZoXCeNbbNX6NHl88cMKQrkA4_tF-dd_sw_XHpv9</recordid><startdate>199902</startdate><enddate>199902</enddate><creator>Ruiz-Bailen, Manuel</creator><creator>Fernandez-Mondejar, Enrique</creator><creator>Hurtado-Ruiz, Benjamin</creator><creator>Colmenero-Ruiz, Manuel</creator><creator>Rivera-Fernandez, Ricardo</creator><creator>Guerrero-Lopez, Francisco</creator><creator>Vazquez-Mata, Guillermo</creator><general>Lippincott Williams & Wilkins, Inc</general><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>199902</creationdate><title>Immediate application of positive-end expiratory pressure is more effective than delayed positive-end expiratory pressure to reduce extravascular lung water</title><author>Ruiz-Bailen, Manuel ; Fernandez-Mondejar, Enrique ; Hurtado-Ruiz, Benjamin ; Colmenero-Ruiz, Manuel ; Rivera-Fernandez, Ricardo ; Guerrero-Lopez, Francisco ; Vazquez-Mata, Guillermo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3856-52e5603e797c54bd68ee0d839217a24e682bf15d657613d1d1d1734727d1e7af3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Analysis of Variance</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Animals</topic><topic>Biological and medical sciences</topic><topic>Carbon Dioxide - blood</topic><topic>Emergency and intensive respiratory care</topic><topic>Extravascular Lung Water - chemistry</topic><topic>Hemodynamics</topic><topic>Intensive care medicine</topic><topic>Medical sciences</topic><topic>Oleic Acid</topic><topic>Oxygen - blood</topic><topic>Positive-Pressure Respiration</topic><topic>Pulmonary Edema - blood</topic><topic>Pulmonary Edema - chemically induced</topic><topic>Pulmonary Edema - physiopathology</topic><topic>Pulmonary Edema - therapy</topic><topic>Random Allocation</topic><topic>Swine</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ruiz-Bailen, Manuel</creatorcontrib><creatorcontrib>Fernandez-Mondejar, Enrique</creatorcontrib><creatorcontrib>Hurtado-Ruiz, Benjamin</creatorcontrib><creatorcontrib>Colmenero-Ruiz, Manuel</creatorcontrib><creatorcontrib>Rivera-Fernandez, Ricardo</creatorcontrib><creatorcontrib>Guerrero-Lopez, Francisco</creatorcontrib><creatorcontrib>Vazquez-Mata, Guillermo</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Critical care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ruiz-Bailen, Manuel</au><au>Fernandez-Mondejar, Enrique</au><au>Hurtado-Ruiz, Benjamin</au><au>Colmenero-Ruiz, Manuel</au><au>Rivera-Fernandez, Ricardo</au><au>Guerrero-Lopez, Francisco</au><au>Vazquez-Mata, Guillermo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Immediate application of positive-end expiratory pressure is more effective than delayed positive-end expiratory pressure to reduce extravascular lung water</atitle><jtitle>Critical care medicine</jtitle><addtitle>Crit Care Med</addtitle><date>1999-02</date><risdate>1999</risdate><volume>27</volume><issue>2</issue><spage>380</spage><epage>384</epage><pages>380-384</pages><issn>0090-3493</issn><eissn>1530-0293</eissn><coden>CCMDC7</coden><abstract>OBJECTIVEto determine by the measurement of extravascular lung water (EVLW) whether the timing of positive-end expiratory pressure (PEEP) application influences the intensity of lung injury.
DESIGNAnimal experimental study.
SETTINGAnimal experimental laboratory.
SUBJECTSMixed-breed pigs (n = 18), aged 4 to 5 mos, weighing 25 to 30 kg.
INTERVENTIONSThe animals were anesthetized and tracheotomized, after which a permeability pulmonary edema was instigated by infusing oleic acid (0.1 /kg) into the central vein. All animals were then randomly divided into three groups. In group 1 (n = 5), 10 cm H2 O of PEEP was applied immediately after the oleic acid infusion and maintained throughout the 6 hrs of the experiment. Group 2 (n = 7) received the same level of PEEP 120 mins after the insult for 4 hrs. Group 3 (n = 6), the control group, was ventilated without PEEP for the six hrs of the experiment.
MEASUREMENTS AND MAIN RESULTSAt the end of the experiment, EVLW was calculated by gravimetric method. EVLW in group 1 (11.46 +/- 2.00 mL/kg) was significantly less than in group 2 (19.12 +/- 2.62 mL/kg) and group 3 (25.81 +/- 1.57 mL/kg), (p < .0001). Oxygenation also showed important differences by the end of the experiment when the PaO2/FIO2 ratio was significantly better in group 1 (467 +/- 73) than in group 2 (180 +/- 82) and group 3 (39 +/- 9), (p < .0001).
CONCLUSIONSThe application of 10 cm H2 O of PEEP reduces EVLW in a time-dependent manner and maximum protective effect is achieved if it is applied immediately after lung injury production. (Crit Care Med 1999; 27:380-384)</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>10075064</pmid><doi>10.1097/00003246-199902000-00046</doi><tpages>5</tpages></addata></record> |
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| ispartof | Critical care medicine, 1999-02, Vol.27 (2), p.380-384 |
| issn | 0090-3493 1530-0293 |
| language | eng |
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| source | Journals@Ovid Ovid Autoload; MEDLINE |
| subjects | Analysis of Variance Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Animals Biological and medical sciences Carbon Dioxide - blood Emergency and intensive respiratory care Extravascular Lung Water - chemistry Hemodynamics Intensive care medicine Medical sciences Oleic Acid Oxygen - blood Positive-Pressure Respiration Pulmonary Edema - blood Pulmonary Edema - chemically induced Pulmonary Edema - physiopathology Pulmonary Edema - therapy Random Allocation Swine Time Factors |
| title | Immediate application of positive-end expiratory pressure is more effective than delayed positive-end expiratory pressure to reduce extravascular lung water |
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