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01-12-2004 | Experimental

Influence of positive end-expiratory pressure (PEEP) on histopathological and bacteriological aspects of pneumonia during low tidal volume mechanical ventilation

Authors: Pierre Emmanuel Charles, Laurent Martin, Manuel Etienne, Delphine Croisier, Lionel Piroth, Catherine Lequeu, Jerome Pugin, Henri Portier, Pascal Chavanet

Published in: Intensive Care Medicine | Issue 12/2004

Abstract

Objective

Ventilatory strategies combining low tidal volume (V_T) with positive end-expiratory pressure (PEEP) are considered to be lung protective. The influence of the PEEP level was investigated on bacteriology and histology in a model of ventilator-associated pneumonia.

Subjects

Nineteen New Zealand rabbits.

Interventions

The animals were mechanically ventilated with a positive inspiratory pressure of 15 cmH₂O and received either a zero end-expiratory pressure (ZEEP, n=6), a 5 cmH₂O PEEP (n=5) or a 10 cmH₂O PEEP (n=4). An inoculum of Enterobacter aerogenes was then instilled intrabronchially. The non-ventilated pneumonia group (n=4) was composed of spontaneously breathing animals which received the same inoculum. Pneumonia was assessed 24 h later.

Main results

The lung bacterial burden was higher in mechanically ventilated animals compared with spontaneously breathing animals. All animals from the latter group had negative spleen cultures. The spleen bacterial concentration was found to be lower in the 5 cmH₂O PEEP group when compared to the ZEEP and 10 cmH₂O PEEP groups (3.1±1.5 vs 4.9±1.1 and 5.0±1.3 log₁₀ cfu/g, respectively; p<0.05). Lung weight and histological score values were lower in the spontaneously breathing animals as well as in the 5 cmH₂O PEEP group compared with the ZEEP and 10 cmH₂O groups.

Conclusions

Mechanical ventilation substantially increased the lung bacterial burden and worsened the histological aspects of pneumonia in this rabbit model. Variations in terms of lung injury and systemic spreading of infection were noted with respect to the ventilatory strategy.

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Title: Influence of positive end-expiratory pressure (PEEP) on histopathological and bacteriological aspects of pneumonia during low tidal volume mechanical ventilation
Authors: Pierre Emmanuel Charles
Laurent Martin
Manuel Etienne
Delphine Croisier
Lionel Piroth
Catherine Lequeu
Jerome Pugin
Henri Portier
Pascal Chavanet
Publication date: 01-12-2004
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 12/2004
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-004-2442-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Influence of positive end-expiratory pressure (PEEP) on histopathological and bacteriological aspects of pneumonia during low tidal volume mechanical ventilation

Abstract

Objective

Subjects

Interventions

Main results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Subjects

Interventions

Main results

Conclusions

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