Effects of pressure control and pressure support ventilation on ventilator induced lung injury in experimental acute respiratory distress syndrome with intra-abdominal hypertension

Santos, Cristina Paludo; Santos, RS; Moraes, Lillian; Samary, CS; Felix, NS; Júnior, PL Fiorio; Morales, MM; Abreu, M. Gama de; Pelosi, Paolo; Schanaider, Alberto; Silva, Pedro L.; Rocco, P.R.M.

doi:10.1186/2197-425x-3-s1-a806

Cited by 1 publication

(1 citation statement)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Within this context, the present study was designed to test the hypothesis that, when delivered at a protective tidal volume, PSV compared to PCV would improve respiratory function, reduce the amount of collapsed areas in the lung, and prevent VILI in experimental extrapulmonary mild ALI with IAH. Part of the results of this study were published previously as an abstract [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of pressure support and pressure-controlled ventilation on lung damage in a model of mild extrapulmonary acute lung injury with intra-abdominal hypertension

Santos

Moraes

et al. 2017

PLoS ONE

View full text Add to dashboard Cite

Intra-abdominal hypertension (IAH) may co-occur with the acute respiratory distress syndrome (ARDS), with significant impact on morbidity and mortality. Lung-protective controlled mechanical ventilation with low tidal volume and positive end-expiratory pressure (PEEP) has been recommended in ARDS. However, mechanical ventilation with spontaneous breathing activity may be beneficial to lung function and reduce lung damage in mild ARDS. We hypothesized that preserving spontaneous breathing activity during pressure support ventilation (PSV) would improve respiratory function and minimize ventilator-induced lung injury (VILI) compared to pressure-controlled ventilation (PCV) in mild extrapulmonary acute lung injury (ALI) with IAH. Thirty Wistar rats (334±55g) received Escherichia coli lipopolysaccharide intraperitoneally (1000μg) to induce mild extrapulmonary ALI. After 24h, animals were anesthetized and randomized to receive PCV or PSV. They were then further randomized into subgroups without or with IAH (15 mmHg) and ventilated with PCV or PSV (PEEP = 5cmH2O, driving pressure adjusted to achieve tidal volume = 6mL/kg) for 1h. Six of the 30 rats were used for molecular biology analysis and were not mechanically ventilated. The main outcome was the effect of PCV versus PSV on mRNA expression of interleukin (IL)-6 in lung tissue. Regardless of whether IAH was present, PSV resulted in lower mean airway pressure (with no differences in peak airway or peak and mean transpulmonary pressures) and less mRNA expression of biomarkers associated with lung inflammation (IL-6) and fibrogenesis (type III procollagen) than PCV. In the presence of IAH, PSV improved oxygenation; decreased alveolar collapse, interstitial edema, and diffuse alveolar damage; and increased expression of surfactant protein B as compared to PCV. In this experimental model of mild extrapulmonary ALI associated with IAH, PSV compared to PCV improved lung function and morphology and reduced type 2 epithelial cell damage.

show abstract

Section: Introductionmentioning

confidence: 99%