Effects of lung recruitment and lower tidal ventilation on gas exchange in rabbits with acute lung injury induced by seawater drowning
10.3760/cma.j.issn.1009-6906.2010.04.001
- VernacularTitle:肺复张联合小潮气量机械通气对海水淹溺致急性肺损伤兔氧合的影响
- Author:
Yu-hong LIU
1
;
Zhi-hai HAN
;
Yun-you DUAN
;
Zhi-cheng ZHANG
;
Yue-kun ZOU
Author Information
1. 海军总医院ICU,北京,100048
- Publication Type:Journal Article
- Keywords:
Acute lung injury;
Lung recruitment maneuvers;
Seawater drowning;
Lower tidal ventilation
- From:
Chinese journal of nautical medicine and hyperbaric medicine
2010;17(4):193-197
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the therapeutic effect and safety of lung recruitment combined with lower tidal ventilation on acute lung injury induced by seawater drowning in rabbits. Methods Eighteen New Zealand rabbits were used for the experiment. Acute lung injury model was developed with intractracheal instillation of seawater (2 ml/kg). Then, the animals had been lower tidal ventilation (6 ml/kg) for three hours. The animals with lung recruitment maneuvers were designated as the experimental group (or the RM group), while those without lung recruitment were designated as the control group. For the RM group,continuous positive airway pressure (CPAP) was applied at a pressure of 2.94 kPa for 20 seconds. Then,arterial blood gas analysis, pulmodynamics, and hemodynamic status were made at various time points. Tumor necrosis factor (TNF-α) and interleukin-6 (IL-6) extracted from serum were also measured following treatment. Pulmonary high - resolution chromatography (HRCT) was also made after three hours of ventilation.Results For the RM group, the partial pressure of arterial oxygen (PaO2) at various time points increased significantly after lung recruitment within two hours(P < 0.05). When a comparison was made between the two groups, PaCO2 for the RM group was higher than that of the control group following lung recruitment at 15 min and 30 min respectively with statistical significance (P < 0.05). Airway plateau pressure (Pplat) decreased markedly(P <0.05)and static compliance increased with statistical significance (P < 0.05). Mean arterial pressure for the RM group decreased in 15 min (P < 0. 05), but almost restored to basic level within 1 h.During recruitment, mean arterial pressure decreased and heart rate increased, but came to normal levels after 30- 90 s. Heart rate at 15 min for the RM group was lower than that of the control group (P < 0.05). However,for both groups, no significant differences could be noted in TN F-α and IL-6 (P > 0.05). Conclusions Lung recruitment combined with lower tidal ventilation could significantly improve gas exchange and lung compliance,and alleviate lung injury, which might be a safe and effective method for the treatment of animals with acute lung injury induced by seawater drowning.
