Establishing lung gas volumes at birth: interaction between positive end-expiratory pressures and tidal volumes in preterm rabbits

Kevin Wheeler, Megan Jane Wallace, Marcus John Kitchen, Arjan B Te Pas, Andreas Fouras, Muhammad Sirajul Islam, Melissa Li-Lian Siew, Robert Arnold Lewis, Colin J Morley, Peter G Davis, Stuart Brian Hooper

Research output: Contribution to journalArticleResearchpeer-review

Abstract

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.
Original languageEnglish
Pages (from-to)734 - 741
Number of pages8
JournalPediatric Research
Volume73
Issue number6
DOIs
Publication statusPublished - 2013

Cite this

Wheeler, Kevin ; Wallace, Megan Jane ; Kitchen, Marcus John ; Te Pas, Arjan B ; Fouras, Andreas ; Islam, Muhammad Sirajul ; Siew, Melissa Li-Lian ; Lewis, Robert Arnold ; Morley, Colin J ; Davis, Peter G ; Hooper, Stuart Brian. / Establishing lung gas volumes at birth: interaction between positive end-expiratory pressures and tidal volumes in preterm rabbits. In: Pediatric Research. 2013 ; Vol. 73, No. 6. pp. 734 - 741.
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title = "Establishing lung gas volumes at birth: interaction between positive end-expiratory pressures and tidal volumes in preterm rabbits",
abstract = "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.",
author = "Kevin Wheeler and Wallace, {Megan Jane} and Kitchen, {Marcus John} and {Te Pas}, {Arjan B} and Andreas Fouras and Islam, {Muhammad Sirajul} and Siew, {Melissa Li-Lian} and Lewis, {Robert Arnold} and Morley, {Colin J} and Davis, {Peter G} and Hooper, {Stuart Brian}",
year = "2013",
doi = "10.1038/pr.2013.48",
language = "English",
volume = "73",
pages = "734 -- 741",
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Establishing lung gas volumes at birth: interaction between positive end-expiratory pressures and tidal volumes in preterm rabbits. / Wheeler, Kevin; Wallace, Megan Jane; Kitchen, Marcus John; Te Pas, Arjan B; Fouras, Andreas; Islam, Muhammad Sirajul; Siew, Melissa Li-Lian; Lewis, Robert Arnold; Morley, Colin J; Davis, Peter G; Hooper, Stuart Brian.

In: Pediatric Research, Vol. 73, No. 6, 2013, p. 734 - 741.

Research output: Contribution to journalArticleResearchpeer-review

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.

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U2 - 10.1038/pr.2013.48

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M3 - Article

VL - 73

SP - 734

EP - 741

JO - Pediatric Research

JF - Pediatric Research

SN - 0031-3998

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ER -