TY - JOUR
T1 - Establishing lung gas volumes at birth: interaction between positive end-expiratory pressures and tidal volumes in preterm rabbits
AU - Wheeler, Kevin
AU - Wallace, Megan Jane
AU - Kitchen, Marcus John
AU - Te Pas, Arjan B
AU - Fouras, Andreas
AU - Islam, Muhammad Sirajul
AU - Siew, Melissa Li-Lian
AU - Lewis, Robert Arnold
AU - Morley, Colin J
AU - Davis, Peter G
AU - Hooper, Stuart Brian
PY - 2013
Y1 - 2013
N2 - We investigated the effects of positive end-expiratory pressure (PEEP) and tidal volume (V T) on lung aeration, pulmonary mechanics, and the distribution of ventilation immediately after birth using a preterm rabbit model.Methods:Sixty preterm rabbits (27 d) received volume-targeted positive pressure ventilation from birth, with one of the 12 combinations of PEEP (0, 5, 8, or 10 cmH 2 O) and V T (4, 8, or 12 ml/kg). Outcomes included functional residual capacity (FRC), peak inflating pressure (PIP), dynamic compliance (Cd), and distribution of ventilation.Results:Increasing PEEP from 0 to 10 cmH 2 O increased FRC by 4 ml/kg, increased Cd by 0.2 ml/kg/cmH 2 O, and reduced PIP by 5 cmH 2 O. Increasing V T from 4 to 12 ml/kg increased FRC by 2 ml/kg, increased Cd by 0.3 ml/kg/cmH 2 O, and increased PIP by 4 cmH 2 O. No effect of V T on FRC occurred at 0 or 5 PEEP, and no effect of PEEP occurred at V T = 4 ml/kg. At 0 PEEP, increasing V T increased the proportion of gas entering the smaller apical regions, whereas at 10 PEEP, increasing V T increased the proportion of gas entering basal regions, from 47 to 63 .Conclusion:Both PEEP and V T have independent, additive effects on FRC, lung mechanics, and the distribution of ventilation during the immediate newborn period.
AB - We investigated the effects of positive end-expiratory pressure (PEEP) and tidal volume (V T) on lung aeration, pulmonary mechanics, and the distribution of ventilation immediately after birth using a preterm rabbit model.Methods:Sixty preterm rabbits (27 d) received volume-targeted positive pressure ventilation from birth, with one of the 12 combinations of PEEP (0, 5, 8, or 10 cmH 2 O) and V T (4, 8, or 12 ml/kg). Outcomes included functional residual capacity (FRC), peak inflating pressure (PIP), dynamic compliance (Cd), and distribution of ventilation.Results:Increasing PEEP from 0 to 10 cmH 2 O increased FRC by 4 ml/kg, increased Cd by 0.2 ml/kg/cmH 2 O, and reduced PIP by 5 cmH 2 O. Increasing V T from 4 to 12 ml/kg increased FRC by 2 ml/kg, increased Cd by 0.3 ml/kg/cmH 2 O, and increased PIP by 4 cmH 2 O. No effect of V T on FRC occurred at 0 or 5 PEEP, and no effect of PEEP occurred at V T = 4 ml/kg. At 0 PEEP, increasing V T increased the proportion of gas entering the smaller apical regions, whereas at 10 PEEP, increasing V T increased the proportion of gas entering basal regions, from 47 to 63 .Conclusion:Both PEEP and V T have independent, additive effects on FRC, lung mechanics, and the distribution of ventilation during the immediate newborn period.
UR - http://www.nature.com/pr/journal/v73/n6/pdf/pr201348a.pdf
U2 - 10.1038/pr.2013.48
DO - 10.1038/pr.2013.48
M3 - Article
SN - 0031-3998
VL - 73
SP - 734
EP - 741
JO - Pediatric Research
JF - Pediatric Research
IS - 6
ER -