TY - JOUR
T1 - Gas exchange and lung inflammation using nasal intermittent positive-pressure ventilation versus synchronized intermittent mandatory ventilation in piglets with saline lavage-induced lung injury
T2 - An observational study
AU - Lampland, Andrea L.
AU - Meyers, Patricia A.
AU - Worwa, Cathy T.
AU - Swanson, Elizabeth C
AU - Mammel, Mark C
PY - 2008/1
Y1 - 2008/1
N2 - OBJECTIVE: Physiologic and pathologic comparison of two modes of assisted ventilation, nasal intermittent positive-pressure ventilation (NIPPV) and synchronized intermittent mandatory ventilation (SIMV), in spontaneously breathing term newborn piglets with saline lavage-induced lung injury. DESIGN: After inducing acute lung injury via repetitive saline lavage, piglets were randomized to NIPPV (n = 12) or SIMV (n = 11) and treated for 6 hrs. SETTING: Clinical laboratory. SUBJECTS: Spontaneously breathing term newborn piglets. INTERVENTIONS: Invasive (SIMV) or noninvasive (NIPPV) assisted ventilation for 6 hrs. MEASUREMENTS: Physiologic parameters and arterial blood gases were continuously monitored. At the conclusion of the study, lung tissue was obtained to analyze for evidence of inflammation, including myeloperoxidase, interleukin-8, and hydrogen peroxide levels, as well as for evidence of pathologic injury. MAIN RESULTS: Piglets treated with NIPPV demonstrated higher arterial blood gas pH (p < .001), lower Paco2 (p < .05), and a lower set respiratory rate (p < .0001) as compared with the SIMV-treated piglets. The piglets in the SIMV group had higher Pao2/Pao2 ratio than those in the NIPPV group (p = .001). There was significantly more interstitial inflammation (p = .04) in the SIMV-treated piglets compared with the NIPPV-treated piglets. Total respiratory rate, heart rate, blood pressure, oxygen saturation, and biochemical markers of lung inflammation were not different between the groups. CONCLUSION: In surfactant-deficient term newborn piglets, NIPPV offers an effective and noninvasive ventilatory strategy with the potential for less pathologic lung inflammation.
AB - OBJECTIVE: Physiologic and pathologic comparison of two modes of assisted ventilation, nasal intermittent positive-pressure ventilation (NIPPV) and synchronized intermittent mandatory ventilation (SIMV), in spontaneously breathing term newborn piglets with saline lavage-induced lung injury. DESIGN: After inducing acute lung injury via repetitive saline lavage, piglets were randomized to NIPPV (n = 12) or SIMV (n = 11) and treated for 6 hrs. SETTING: Clinical laboratory. SUBJECTS: Spontaneously breathing term newborn piglets. INTERVENTIONS: Invasive (SIMV) or noninvasive (NIPPV) assisted ventilation for 6 hrs. MEASUREMENTS: Physiologic parameters and arterial blood gases were continuously monitored. At the conclusion of the study, lung tissue was obtained to analyze for evidence of inflammation, including myeloperoxidase, interleukin-8, and hydrogen peroxide levels, as well as for evidence of pathologic injury. MAIN RESULTS: Piglets treated with NIPPV demonstrated higher arterial blood gas pH (p < .001), lower Paco2 (p < .05), and a lower set respiratory rate (p < .0001) as compared with the SIMV-treated piglets. The piglets in the SIMV group had higher Pao2/Pao2 ratio than those in the NIPPV group (p = .001). There was significantly more interstitial inflammation (p = .04) in the SIMV-treated piglets compared with the NIPPV-treated piglets. Total respiratory rate, heart rate, blood pressure, oxygen saturation, and biochemical markers of lung inflammation were not different between the groups. CONCLUSION: In surfactant-deficient term newborn piglets, NIPPV offers an effective and noninvasive ventilatory strategy with the potential for less pathologic lung inflammation.
KW - Animal model
KW - Continuous positive airway pressure
KW - Lung injury
KW - Mechanical ventilation
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U2 - 10.1097/01.CCM.0000295311.61378.7D
DO - 10.1097/01.CCM.0000295311.61378.7D
M3 - Article
C2 - 18090370
AN - SCOPUS:37549011766
SN - 0090-3493
VL - 36
SP - 183
EP - 187
JO - Critical care medicine
JF - Critical care medicine
IS - 1
ER -