Does Hypercapnic Acidosis, induced by Adding CO2 to Inspired Gas, Have Protective Effect in a Ventilator-induced Lung Injury?.
10.3346/jkms.2005.20.5.764
- Author:
Chang Min PARK
1
;
Sung Chul LIM
;
Yu Il KIM
;
Kyu Sik KIM
;
In Jae OH
;
Soo Ock KIM
;
Young Chul KIM
Author Information
1. Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea. lscmd@chonnam.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Ventilator-induced lung Injury;
Ventilator, Mechanical;
Hypercapnia;
Acidosis, Respiratory
- MeSH:
Acidosis, Respiratory/*chemically induced/complications/diagnosis/physiopathology;
Administration, Inhalation;
Animals;
Carbon Dioxide/*administration and dosage;
Hypercapnia/*chemically induced/complications/diagnosis/physiopathology;
Inhalation;
Pulmonary Gas Exchange;
Rabbits;
Research Support, Non-U.S. Gov't;
Respiration, Artificial/*adverse effects;
Respiratory Distress Syndrome, Adult/diagnosis/*etiology/physiopathology/*prevention and control;
Treatment Outcome
- From:Journal of Korean Medical Science
2005;20(5):764-769
- CountryRepublic of Korea
- Language:English
-
Abstract:
To investigate whether hypercapnic acidosis, induced by adding CO2 to inspired gas, would be protective effect against ventilator-induced lung injury (VILI), we ventilated 55 normal white rabbits for 6 hr or until PaO2/FIO2 <200 mmHg. Control group (n=15) was ventilated with peak inspiratory pressure (PIP) of 15 cm H2O, positive end-expiratory pressure (PEEP) of 3 cm H2O, an inspiration-to-expiration ratio of 1:2, and an inspired oxygen fraction (FIO2) of 0.40. High pressure hypercapnic group (HPHC; n=20) was ventilated with PIP of 30 cm H2O, PEEP of 0 cm H2O, and FIO2 of 0.40. Carbon dioxide was introduced into the inspiratory limb of the ventilator circuit, as necessary to maintain hypercapnia (PaCO2, 65 to 75 mmHg). High pressure normocapnic group (HPNC; n=20) was ventilated with same setting of HPHC, except normocapnia (PaCO2, 35 to 45 mmHg). Bronchoalveolar lavage fluid (BALF) lactate dehydrogenase, aspartate aminotransferase, interleukin-8 were significantly higher in high pressure ventilator group than control group (p<0.05). Wet weight to dry weight (WW/DW) and histologic scores were significantly higher in high pressure ventilator group than control group (p<0.05). However, there were no significant differences in oxygenation, BALF inflammatory markers, WW/DW and histologic scores between HPHC and HPNC groups. These findings suggest that hypercapnic acidosis at least induced by CO2 insufflation would not be protective effect against VILI in this model.
