Positive end-expiratory pressure alters the severity and spatial heterogeneity of ventilator-induced lung injury: an argument for cyclical airway collapse.
Positive end-expiratory pressure alters the severity and spatial heterogeneity of ventilator-induced lung injury: an argument for cyclical airway collapse.
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DOI：
10.1016/j.jcrc.2008.04.005
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发表时间：
2009-06
影响因子：
3.7
通讯作者：
Altemeier, William A.
中科院分区：
文献类型：
--
作者：
Sinclair, Scott E.;Chi, Emil;Lin, Hen-I;Altemeier, William A.
呼吸机诱导的肺损伤（VILI）是公认的机械通气并发症。尽管机械通气导致肺损伤的具体机制仍然是一个活跃的研究领域，但肺泡过度扩张和周期性气道塌陷和复张都被认为是促成原因。我们假设，与PEEP = 8 cmH2O相比，在没有PEEP的情况下机械通气会导致VILI更严重，且区域可变。为了验证这一假设，麻醉的仰卧家兔进行机械通气，吸气末压为28 cm H2O，PEEP为0或8 cm H2O，持续4小时。通过组织学评分确定局部肺损伤。在没有PEEP的情况下，肺损伤是区域可变的，在背尾侧肺中最大。这种区域性损伤的异质性被废除的PEEP = 8厘米H2O。这些结果表明，VILI是区域异质性和空间相关的周期性气道塌陷和招聘是最有可能发生的地区。
Ventilator-induced lung injury (VILI) is a recognized complication of mechanical ventilation. Although the specific mechanism by which mechanical ventilation causes lung injury remains an active area of study, both alveolar overdistension and cyclical airway collapse and recruitment have been suggested as contributing causes. We hypothesized that mechanical ventilation in the absence of PEEP causes VILI to be more severe and regionally variable as compared with PEEP = 8 cmH2O. To test this hypothesis, anesthetized, supine rabbits were mechanically ventilated with an end inspiratory pressure of 28-cm H2O and either 0- or 8-cmH2O PEEP over 4-hours. Regional lung injury was determined by histological scoring. In the absence of PEEP, lung injury was regionally variable and greatest in the dorsal-caudal lung. This regional injury heterogeneity was abolished by the addition of PEEP = 8 cm H2O. These results suggest that VILI is regionally heterogeneous and spatially correlates with regions in which cyclical airway collapse and recruitment is most likely to occur.
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DOI：
10.1164/rccm.200112-117oc
发表时间：
2002-08-01
影响因子：
24.7
作者：
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发表时间：
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影响因子：
24.7
作者：
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DOI：
10.1164/ajrccm.149.5.8173774
发表时间：
1994-05-01
影响因子：
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作者：
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