Journal article
Variable ventilation improves ventilation and lung compliance in preterm lambs
Intensive Care Medicine, Vol.37(8), pp.1352-1359
2011
Abstract
Purpose: In adult animals, ventilation with variable tidal volume and rate improves lung mechanics, arterial oxygenation and ventilation compared to a monotonously controlled ventilation pattern. We assessed the physiological consequences of variable ventilation in the immature lung. Methods: Lambs delivered at 129 days (term = 150 days) were euthanised (n = 9) or anaesthetised, tracheostomised and suctioned prior to prophylactic intra-tracheal surfactant instillation (Curosurf®, 100 mg/kg) and commencement of controlled ventilation (50 breaths/min, tidal volume 7.7 ± 0.8 mL/kg). Volume history was standardised at 20 min with two sustained (3 s) inflations to 30 cmH 2O followed immediately by measurement of baseline dynamic lung mechanics (FlexiVent™, Scireq, Canada). Ventilation was continued according to prior randomisation (variable or conventional ventilation). For variable ventilation (n = 9), breath-to-breath tidal volume and respiratory rate varied but intra-breath minute volume (MV) and average tidal volume were equivalent to the conventional ventilation group with fixed tidal volume and rate (n = 7). Lung mechanics and gas exchange were measured at intervals. Lambs were euthanised at 2 h. Inflammatory cell counts and protein from bronchoalveolar lavage fluid and lung tissue cytokine mRNA were quantified. Results: At study completion, PaCO 2 (p = 0.026) and mean airway pressure (p = 0.002) were lower and pH (p = 0.047), ventilation efficiency index (p = 0.021) and dynamic compliance were higher (p = 0.003) in lambs on variable rather than conventional ventilation. However, oxygenation indices and post-mortem static compliances were not different between groups. Conclusion: Variable ventilation improves ventilation efficiency and in vivo lung compliance in the preterm lung, but unlike adult models, had no effect on arterial oxygenation.
Details
- Title
- Variable ventilation improves ventilation and lung compliance in preterm lambs
- Authors/Creators
- J.J. Pillow (Author/Creator)G.C. Musk (Author/Creator)C.M. McLean (Author/Creator)G.R. Polglase (Author/Creator)R.G.B. Dalton (Author/Creator)A.H. Jobe (Author/Creator)B. Suki (Author/Creator)
- Publication Details
- Intensive Care Medicine, Vol.37(8), pp.1352-1359
- Publisher
- Springer Verlag
- Identifiers
- 991005543669907891
- Copyright
- © 2011 Copyright jointly held by Springer and ESICM.
- Murdoch Affiliation
- Murdoch University
- Language
- English
- Resource Type
- Journal article
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- Collaboration types
- Domestic collaboration
- International collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.154 Assisted Ventilation
- 1.154.277 Mechanical Ventilation
- Web Of Science research areas
- Critical Care Medicine
- ESI research areas
- Clinical Medicine