Skip to main content
Top
Published in: Critical Care 2/2010

Open Access 01-04-2010 | Research

Alveolar fluid clearance in healthy pigs and influence of positive end-expiratory pressure

Authors: Manuel García-Delgado, Ángel Touma-Fernández, Virginia Chamorro-Marín, Antonio Ruiz-Aguilar, Eduardo Aguilar-Alonso, Enrique Fernández-Mondéjar

Published in: Critical Care | Issue 2/2010

Login to get access

Abstract

Introduction

The objectives were to characterize alveolar fluid clearance (AFC) in pigs with normal lungs and to analyze the effect of immediate application of positive end-expiratory pressure (PEEP).

Methods

Animals (n = 25) were mechanically ventilated and divided into four groups: small edema (SE) group, producing pulmonary edema (PE) by intratracheal instillation of 4 ml/kg of saline solution; small edema with PEEP (SE + PEEP) group, same as previous but applying PEEP of 10 cmH2O; large edema (LE) group, producing PE by instillation of 10 ml/kg of saline solution; and large edema with PEEP (LE + PEEP) group, same as LE group but applying PEEP of 10 cmH2O. AFC was estimated from differences in extravascular lung water values obtained by transpulmonary thermodilution method.

Results

At one hour, AFC was 19.4% in SE group and 18.0% in LE group. In the SE + PEEP group, the AFC rate was higher at one hour than at subsequent time points and higher than in the SE group (45.4% vs. 19.4% at one hour, P < 0.05). The AFC rate was also significantly higher in the LE + PEEP than in the LE group at three hours and four hours.

Conclusions

In this pig model, the AFC rate is around 20% at one hour and around 50% at four hours, regardless of the amount of edema, and is increased by the application of PEEP.
Appendix
Available only for authorised users
Literature
1.
go back to reference Berthiaume Y, Folkesson HG, Matthay MA: Lung edema clearance: 20 years of progress. Invited review: alveolar edema fluid clearance in the injured lung. J Appl Physiol 2002, 93: 2207-2213.CrossRefPubMed Berthiaume Y, Folkesson HG, Matthay MA: Lung edema clearance: 20 years of progress. Invited review: alveolar edema fluid clearance in the injured lung. J Appl Physiol 2002, 93: 2207-2213.CrossRefPubMed
2.
go back to reference Morty RE, Eickelberg O, Seeger W: Alveolar fluid clearance in acute lung injury: what have we learned from animal models and clinical studies? Intensive Care Med 2007, 33: 1229-1240. 10.1007/s00134-007-0662-7CrossRefPubMed Morty RE, Eickelberg O, Seeger W: Alveolar fluid clearance in acute lung injury: what have we learned from animal models and clinical studies? Intensive Care Med 2007, 33: 1229-1240. 10.1007/s00134-007-0662-7CrossRefPubMed
3.
go back to reference Colmenero-Ruiz M, Fernández-Mondéjar E, Garcia-Delgado M, Rojas M, Lozano L, Poyatos ME: [Current concepts of pathophysiology, monitoring and resolution of pulmonary edema]. Med Intensiva 2006, 30: 322-330. 10.1016/S0210-5691(06)74537-5CrossRefPubMed Colmenero-Ruiz M, Fernández-Mondéjar E, Garcia-Delgado M, Rojas M, Lozano L, Poyatos ME: [Current concepts of pathophysiology, monitoring and resolution of pulmonary edema]. Med Intensiva 2006, 30: 322-330. 10.1016/S0210-5691(06)74537-5CrossRefPubMed
4.
go back to reference Matthay MA, Clerici C, Saumon G: Lung edema clearance: 20 years of progress. Invited review: active fluid clearance from the distal air spaces of the lung. J Appl Physiol 2002, 93: 1533-1541.CrossRefPubMed Matthay MA, Clerici C, Saumon G: Lung edema clearance: 20 years of progress. Invited review: active fluid clearance from the distal air spaces of the lung. J Appl Physiol 2002, 93: 1533-1541.CrossRefPubMed
5.
go back to reference Berthiaume Y, Broaddus VC, Gropper MA, Tanita T, Matthay MA: Alveolar liquid and protein clearance from normal dog lungs. J Appl Physiol 1988, 65: 585-593.PubMed Berthiaume Y, Broaddus VC, Gropper MA, Tanita T, Matthay MA: Alveolar liquid and protein clearance from normal dog lungs. J Appl Physiol 1988, 65: 585-593.PubMed
6.
go back to reference Matthay MA, Berthiaume Y, Staub NC: Long-term clearance of liquid and protein from the lungs of unanesthetized sheep. J Appl Physiol 1985, 59: 928-934.PubMed Matthay MA, Berthiaume Y, Staub NC: Long-term clearance of liquid and protein from the lungs of unanesthetized sheep. J Appl Physiol 1985, 59: 928-934.PubMed
7.
go back to reference Berthiaume Y, Staub NC, Matthay MA: Beta-adrenergic agonists increase lung liquid clearance in anesthetized sheep. J Clin Invest 1987, 79: 335-343. 10.1172/JCI112817PubMedCentralCrossRefPubMed Berthiaume Y, Staub NC, Matthay MA: Beta-adrenergic agonists increase lung liquid clearance in anesthetized sheep. J Clin Invest 1987, 79: 335-343. 10.1172/JCI112817PubMedCentralCrossRefPubMed
8.
go back to reference Fukuda N, Folkesson HG, Matthay MA: Relationship of interstitial fluid volume to alveolar fluid clearance in mice: ventilated versus in situ studies. J Appl Physiol 2000, 89: 672-679.PubMed Fukuda N, Folkesson HG, Matthay MA: Relationship of interstitial fluid volume to alveolar fluid clearance in mice: ventilated versus in situ studies. J Appl Physiol 2000, 89: 672-679.PubMed
9.
go back to reference Garat C, Carter EP, Matthay MA: New in situ mouse model to quantify alveolar epithelial fluid clearance. J Appl Physiol 1998, 84: 1763-1767.PubMed Garat C, Carter EP, Matthay MA: New in situ mouse model to quantify alveolar epithelial fluid clearance. J Appl Physiol 1998, 84: 1763-1767.PubMed
10.
go back to reference Jayr C, Garat C, Meignan M, Pittet JF, Zelter M, Matthay MA: Alveolar liquid and protein clearance in anesthetized ventilated rats. J Appl Physiol 1994, 76: 2636-2642. 10.1063/1.357560CrossRefPubMed Jayr C, Garat C, Meignan M, Pittet JF, Zelter M, Matthay MA: Alveolar liquid and protein clearance in anesthetized ventilated rats. J Appl Physiol 1994, 76: 2636-2642. 10.1063/1.357560CrossRefPubMed
11.
go back to reference Norlin A, Finley N, Abedinpour P, Folkesson HG: Alveolar liquid clearance in the anesthetized ventilated guinea pig. Am J Physiol 1998, 274: L235-L243.PubMed Norlin A, Finley N, Abedinpour P, Folkesson HG: Alveolar liquid clearance in the anesthetized ventilated guinea pig. Am J Physiol 1998, 274: L235-L243.PubMed
12.
go back to reference Smedira N, Gates L, Hastings R, Jayr C, Sakuma T, Pittet JF, Matthay MA: Alveolar and lung liquid clearance in anesthetized rabbits. J Appl Physiol 1991, 70: 1827-1835.PubMed Smedira N, Gates L, Hastings R, Jayr C, Sakuma T, Pittet JF, Matthay MA: Alveolar and lung liquid clearance in anesthetized rabbits. J Appl Physiol 1991, 70: 1827-1835.PubMed
13.
go back to reference Ware LB, Matthay MA: Alveolar fluid clearance is impaired in the majority of patients with acute lung injury and the acute respiratory distress syndrome. Am J Respir Crit Care Med 2001, 163: 1376-1383.CrossRefPubMed Ware LB, Matthay MA: Alveolar fluid clearance is impaired in the majority of patients with acute lung injury and the acute respiratory distress syndrome. Am J Respir Crit Care Med 2001, 163: 1376-1383.CrossRefPubMed
14.
go back to reference Sakuma T, Hida M, Nambu Y, Osanai K, Toga H, Takahashi K, Ohya N, Inoue M, Watanabe Y: Effects of hypoxia on alveolar fluid transport capacity in rat lungs. J Appl Physiol 2001, 91: 1766-1774.PubMed Sakuma T, Hida M, Nambu Y, Osanai K, Toga H, Takahashi K, Ohya N, Inoue M, Watanabe Y: Effects of hypoxia on alveolar fluid transport capacity in rat lungs. J Appl Physiol 2001, 91: 1766-1774.PubMed
15.
16.
go back to reference Ware LB, Matthay MA: The acute respiratory distress syndrome. N Engl J Med 2000, 342: 1334-1349. 10.1056/NEJM200005043421806CrossRefPubMed Ware LB, Matthay MA: The acute respiratory distress syndrome. N Engl J Med 2000, 342: 1334-1349. 10.1056/NEJM200005043421806CrossRefPubMed
17.
go back to reference Wang PM, Ashino Y, Ichimura H, Bhattacharya J: Rapid alveolar liquid removal by a novel convective mechanism. Am J Physiol Lung Cell Mol Physiol 2001, 281: L1327-L1334.PubMed Wang PM, Ashino Y, Ichimura H, Bhattacharya J: Rapid alveolar liquid removal by a novel convective mechanism. Am J Physiol Lung Cell Mol Physiol 2001, 281: L1327-L1334.PubMed
18.
go back to reference Modelska K, Matthay MA, McElroy MC, Pittet JF: Upregulation of alveolar liquid clearance after fluid resuscitation for hemorrhagic shock in rats. Am J Physiol 1997, 273: L305-L314.PubMed Modelska K, Matthay MA, McElroy MC, Pittet JF: Upregulation of alveolar liquid clearance after fluid resuscitation for hemorrhagic shock in rats. Am J Physiol 1997, 273: L305-L314.PubMed
19.
go back to reference Pittet JF, Wiener-Kronish JP, McElroy MC, Folkesson HG, Matthay MA: Stimulation of lung epithelial liquid clearance by endogenous release of catecholamines in septic shock in anesthetized rats. J Clin Invest 1994, 94: 663-671. 10.1172/JCI117383PubMedCentralCrossRefPubMed Pittet JF, Wiener-Kronish JP, McElroy MC, Folkesson HG, Matthay MA: Stimulation of lung epithelial liquid clearance by endogenous release of catecholamines in septic shock in anesthetized rats. J Clin Invest 1994, 94: 663-671. 10.1172/JCI117383PubMedCentralCrossRefPubMed
20.
go back to reference Lane SM, Maender KC, Awender NE, Maron MB: Adrenal epinephrine increases alveolar liquid clearance in a canine model of neurogenic pulmonary edema. Am J Respir Crit Care Med 1998, 158: 760-768.CrossRefPubMed Lane SM, Maender KC, Awender NE, Maron MB: Adrenal epinephrine increases alveolar liquid clearance in a canine model of neurogenic pulmonary edema. Am J Respir Crit Care Med 1998, 158: 760-768.CrossRefPubMed
21.
go back to reference Campbell AR, Folkesson HG, Berthiaume Y, Gutkowska J, Suzuki S, Matthay MA: Alveolar epithelial fluid clearance persists in the presence of moderate left atrial hypertension in sheep. J Appl Physiol 1999, 86: 139-151.PubMed Campbell AR, Folkesson HG, Berthiaume Y, Gutkowska J, Suzuki S, Matthay MA: Alveolar epithelial fluid clearance persists in the presence of moderate left atrial hypertension in sheep. J Appl Physiol 1999, 86: 139-151.PubMed
22.
go back to reference Verghese GM, Ware LB, Matthay BA, Matthay MA: Alveolar epithelial fluid transport and the resolution of clinically severe hydrostatic pulmonary edema. J Appl Physiol 1999, 87: 1301-1312.PubMed Verghese GM, Ware LB, Matthay BA, Matthay MA: Alveolar epithelial fluid transport and the resolution of clinically severe hydrostatic pulmonary edema. J Appl Physiol 1999, 87: 1301-1312.PubMed
23.
go back to reference Serikov VB, Grady M, Matthay MA: Effect of temperature on alveolar liquid and protein clearance in an in situ perfused goat lung. J Appl Physiol 1993, 75: 940-947.PubMed Serikov VB, Grady M, Matthay MA: Effect of temperature on alveolar liquid and protein clearance in an in situ perfused goat lung. J Appl Physiol 1993, 75: 940-947.PubMed
24.
go back to reference Sakuma T, Okaniwa G, Nakada T, Nishimura T, Fujimura S, Matthay MA: Alveolar fluid clearance in the resected human lung. Am J Respir Crit Care Med 1994, 150: 305-310.CrossRefPubMed Sakuma T, Okaniwa G, Nakada T, Nishimura T, Fujimura S, Matthay MA: Alveolar fluid clearance in the resected human lung. Am J Respir Crit Care Med 1994, 150: 305-310.CrossRefPubMed
25.
go back to reference Brismar B, Hedenstierna G, Lundquist H, Strandberg A, Svensson L, Tokics L: Pulmonary densities during anesthesia with muscular relaxation, a proposal of atelectasis. Anesthesiology 1985, 62: 422-428. 10.1097/00000542-198504000-00009CrossRefPubMed Brismar B, Hedenstierna G, Lundquist H, Strandberg A, Svensson L, Tokics L: Pulmonary densities during anesthesia with muscular relaxation, a proposal of atelectasis. Anesthesiology 1985, 62: 422-428. 10.1097/00000542-198504000-00009CrossRefPubMed
26.
go back to reference Fernández-Mondéjar E, Rivera-Fernández R, García-Delgado M, Touma A, Machado J, Chavero J: Small increases in extravascular lung water are accurately detected by transpulmonary thermodilution. J Trauma 2005, 59: 1420-1423. 10.1097/01.ta.0000198360.01080.42CrossRefPubMed Fernández-Mondéjar E, Rivera-Fernández R, García-Delgado M, Touma A, Machado J, Chavero J: Small increases in extravascular lung water are accurately detected by transpulmonary thermodilution. J Trauma 2005, 59: 1420-1423. 10.1097/01.ta.0000198360.01080.42CrossRefPubMed
27.
go back to reference Michard F, Schachtrupp A, Toens C: Factors influencing the estimation of extravascular lung water by transpulmonary thermodilution in critically ill patients. Crit Care Med 2005, 33: 1243-1247. 10.1097/01.CCM.0000164566.23147.35CrossRefPubMed Michard F, Schachtrupp A, Toens C: Factors influencing the estimation of extravascular lung water by transpulmonary thermodilution in critically ill patients. Crit Care Med 2005, 33: 1243-1247. 10.1097/01.CCM.0000164566.23147.35CrossRefPubMed
28.
go back to reference Saul GM, Feeley TW, Mihm FG: Effect of graded administration of PEEP on lung water in noncardiogenic pulmonary edema. Crit Care Med 1982, 10: 667-669.CrossRefPubMed Saul GM, Feeley TW, Mihm FG: Effect of graded administration of PEEP on lung water in noncardiogenic pulmonary edema. Crit Care Med 1982, 10: 667-669.CrossRefPubMed
Metadata
Title
Alveolar fluid clearance in healthy pigs and influence of positive end-expiratory pressure
Authors
Manuel García-Delgado
Ángel Touma-Fernández
Virginia Chamorro-Marín
Antonio Ruiz-Aguilar
Eduardo Aguilar-Alonso
Enrique Fernández-Mondéjar
Publication date
01-04-2010
Publisher
BioMed Central
Published in
Critical Care / Issue 2/2010
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc8914

Other articles of this Issue 2/2010

Critical Care 2/2010 Go to the issue