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Alveolar fluid clearance in healthy pigs and influence of positive end-expiratory pressure

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Date

2010-03-16

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García-Delgado, Manuel
Touma-Fernández, Ángel
Chamorro-Marín, Virginia
Ruiz-Aguilar, Antonio
Aguilar-Alonso, Eduardo
Fernández-Mondéjar, Enrique

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BioMed Central
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INTRODUCTION The objectives were to characterize alveolar fluid clearance (AFC) in pigs with normal lungs and to analyze the effect of immediate application of positive end-expiratory pressure (PEEP). METHODS Animals (n = 25) were mechanically ventilated and divided into four groups: small edema (SE) group, producing pulmonary edema (PE) by intratracheal instillation of 4 ml/kg of saline solution; small edema with PEEP (SE + PEEP) group, same as previous but applying PEEP of 10 cmH2O; large edema (LE) group, producing PE by instillation of 10 ml/kg of saline solution; and large edema with PEEP (LE + PEEP) group, same as LE group but applying PEEP of 10 cmH2O. AFC was estimated from differences in extravascular lung water values obtained by transpulmonary thermodilution method. RESULTS At one hour, AFC was 19.4% in SE group and 18.0% in LE group. In the SE + PEEP group, the AFC rate was higher at one hour than at subsequent time points and higher than in the SE group (45.4% vs. 19.4% at one hour, P < 0.05). The AFC rate was also significantly higher in the LE + PEEP than in the LE group at three hours and four hours. CONCLUSIONS In this pig model, the AFC rate is around 20% at one hour and around 50% at four hours, regardless of the amount of edema, and is increased by the application of PEEP.

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Journal Article;

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Medical Subject Headings::Anatomy::Fluids and Secretions::Body Fluids::Extracellular Fluid::Extravascular Lung Water
Medical Subject Headings::Phenomena and Processes::Circulatory and Respiratory Physiological Phenomena::Cardiovascular Physiological Phenomena::Hemodynamics
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Models, Animal
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Airway Management::Respiration, Artificial::Positive-Pressure Respiration
Medical Subject Headings::Diseases::Respiratory Tract Diseases::Lung Diseases::Pulmonary Edema
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Artiodactyla::Swine
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome
Medical Subject Headings::Organisms::Eukaryota::Animals

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Animales, Agua Pulmonar Extravascular, Hemodinámica, Modelos Animales, Respiración con Presión Positiva, Edema Pulmonar, Porcinos, Resultado del Tratamiento

Citation

García-Delgado M, Touma-Fernández A, Chamorro-Marín V, Ruiz-Aguilar A, Aguilar-Alonso E , Fernández-Mondéjar E.Alveolar fluid clearance in healthy pigs and influence of positive end-expiratory pressure.Crit Care. 2010;14(2):R36