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Intensive Care Medicine

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01-04-2007 | Experimental

Alveolar edema dispersion and alveolar protein permeability during high volume ventilation: effect of positive end-expiratory pressure

Authors: Nicolas de Prost, Damien Roux, Didier Dreyfuss, Jean-Damien Ricard, Dominique Le Guludec, Georges Saumon

Published in: Intensive Care Medicine | Issue 4/2007

Abstract

Objectives

To evaluate whether PEEP affects intrapulmonary alveolar edema liquid movement and alveolar permeability to proteins during high volume ventilation.

Design and setting

Experimental study in an animal research laboratory.

Subjects

46 male Wistar rats.

Interventions

A ^99mTc-labeled albumin solution was instilled in a distal airway to produce a zone of alveolar flooding. Conventional ventilation (CV) was applied for 30 min followed by various ventilation strategies for 3 h: CV, spontaneous breathing, and high volume ventilation with different PEEP levels (0, 6, and 8 cmH₂O) and different tidal volumes. Dispersion of the instilled liquid and systemic leakage of ^99mTc-albumin from the lungs were studied by scintigraphy.

Measurements and results

The instillation protocol produced a zone of alveolar flooding that stayed localized during CV or spontaneous breathing. High volume ventilation dispersed alveolar liquid in the lungs. This dispersion was prevented by PEEP even when tidal volume was the same and thus end-inspiratory pressure higher. High volume ventilation resulted in the leakage of instilled ^99mTc-albumin from the lungs. This increase in alveolar albumin permeability was reduced by PEEP. Albumin permeability was more affected by the amplitude of tidal excursions than by overall lung distension.

Conclusions

PEEP prevents the dispersion of alveolar edema liquid in the lungs and lessens the increase in alveolar albumin permeability due to high volume ventilation.

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Title: Alveolar edema dispersion and alveolar protein permeability during high volume ventilation: effect of positive end-expiratory pressure
Authors: Nicolas de Prost
Damien Roux
Didier Dreyfuss
Jean-Damien Ricard
Dominique Le Guludec
Georges Saumon
Publication date: 01-04-2007
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 4/2007
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-007-0575-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Alveolar edema dispersion and alveolar protein permeability during high volume ventilation: effect of positive end-expiratory pressure

Abstract

Objectives

Design and setting

Subjects

Interventions

Measurements and results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Design and setting

Subjects

Interventions

Measurements and results

Conclusions

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