Continuous Negative Extrathoracic Pressure and Positive End-Expiratory Pressure: A Comparative Study in Escherichia coli Endotoxin-Treated Neonatal Piglets
Continuous Negative Extrathoracic Pressure and Positive End-Expiratory Pressure: A Comparative Study in Escherichia coli Endotoxin-Treated Neonatal Piglets
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持续胸外负压和呼气末正压：大肠杆菌内毒素处理的新生仔猪的比较研究
DOI：
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发表时间：
1995
期刊：
影响因子：
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通讯作者：
D. Easa
中科院分区：
文献类型：
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作者：
T. Mundie;K. Finn;V. Balaraman;S. Sood;D. Easa
最近的临床研究表明，使用持续胸外负压（CNEP）联合间歇性强制通气（IMV），肺气体交换的改善可能是由于肺血流量增加。因此，我们研究了给药大肠杆菌内毒素诱导新生儿肺动脉高压后CNEP与呼气末正压（PEEP）的关系。两个试验组，每组6头仔猪，在内毒素输注后2小时开始进行6 cm h2o CNEP和6 cm h2o PEEP 3个30 min交替周期。呼气末肺容量（EELV）在CNEP（28±2 mL/kg）和PEEP（29±2 mL/kg）组均较基线（13±2 mL/kg）增加。此外，CNEP组与PEEP组相比，PaO 2从基线升高（106±9至135±7 mm Hg）与PEEP组（114±11至132±6 mm Hg）相似。此外，CNEP和PEEP在动态肺顺应性、EELV、肺阻力、血气指标或血流动力学（包括经壁肺动脉压和肺血管阻力）方面均无差异。在经肺压和经呼吸压相等的情况下，CNEP合并IMV在生理上等同于PEEP和IMV。
Recent clinical studies have suggested that improvement in pulmonary gas exchange with the use of continuous negative extrathoracic pressure (CNEP) in conjunction with intermittent mandatory ventilation (IMV) may be due to increased pulmonary blood flow. Accordingly, we investigated the effects of CNEP vs positive end-expiratory pressure (PEEP) in ventilated neonatal piglets after Escherichia coli endotoxin was administered to induce pulmonary hypertension. Two experimental groups of piglets with six in each, were subjected to three 30-min alternating periods—6 cm H 2 O CNEP with 6 cm H 2 O PEEP, beginning 2 h after endotoxin infusion. End-expiratory lung volume (EELV) increased similarly from baseline (13±2 mL/kg) with both CNEP (28±2 mL/kg) and PEEP (29±2 mL/kg). In addition, the increase in PaO 2 from baseline with CNEP (106±9 to 135±7 mm Hg) was similar to that with PEEP (114±11 to 132±6 mm Hg). Further, no differences were found in dynamic lung compliance, EELV, lung resistance, blood gas indexes, or hemodynamics, including transmural pulmonary artery pressure and pulmonary vascular resistance between CNEP and PEEP. With transpulmonary pressure and transrespiratory pressure equal, CNEP in tandem with IMV is physiologically equivalent to PEEP and IMV.
影响因子：
5.4
作者：
Shinbori, T;Walczak, H;Krammer, PH
通讯作者：
Krammer, PH