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Intensive Care Medicine

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01-11-2003 | Experimental

PEEP decreases atelectasis and extravascular lung water but not lung tissue volume in surfactant-washout lung injury

Authors: Thomas Luecke, Harry Roth, Peter Herrmann, Alf Joachim, Gerald Weisser, Paolo Pelosi, Michael Quintel

Published in: Intensive Care Medicine | Issue 11/2003

Abstract

Objective

To examine the effects of positive end-expiratory pressure (PEEP) on extravascular lung water (EVLW), lung tissue, and lung volume.

Design and setting

Experimental animal study at a university research facility.

Subjects

Fifteen adult sheep.

Interventions

All animals were studied before and after saline washout-induced lung injury while ventilated with sequentially increasing PEEP (0, 7, 14, or 21 cmH₂O).

Measurements and results

Lung volume was determined by computed tomography and EVLW by the thermal dye dilution technique. Saline washout significantly increased lung tissue volume (21±3 to 37±5 ml/kg) and EVLW (9±2 to 36±9 ml/kg). While increasing levels of PEEP reduced EVLW (30±7, 24±8, and 18±4 ml/kg), lung tissue volume remained constant. Total lung volume significantly increased (50±8 ml/kg at PEEP 0 to 77±12 ml/kg at PEEP 21). Nonaerated lung volume significantly decreased and was closely correlated with the changes in EVLW (r=0.67). In addition, a highly significant correlation was found between PEEP-induced decrease in nonaerated lung volume and decrease in transpulmonary shunt (r=0.83).

Conclusions

The main findings are as follows: (a) PEEP effectively decreases EVLW. (b) The decrease in EVLW is closely correlated with the PEEP-induced decrease in nonaerated lung volume, making EVLW a valuable bedside parameter indicating alveolar recruitment, similar to measurements of transpulmonary shunt. (c) As excess tissue volume remained constant, however, EVLW may not be suitable to reflect overall severity of lung disease

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Title: PEEP decreases atelectasis and extravascular lung water but not lung tissue volume in surfactant-washout lung injury
Authors: Thomas Luecke
Harry Roth
Peter Herrmann
Alf Joachim
Gerald Weisser
Paolo Pelosi
Michael Quintel
Publication date: 01-11-2003
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 11/2003
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-003-1906-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

PEEP decreases atelectasis and extravascular lung water but not lung tissue volume in surfactant-washout lung injury

Abstract

Objective

Design and setting

Subjects

Interventions

Measurements and results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design and setting

Subjects

Interventions

Measurements and results

Conclusions

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