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Continuous tracheal gas insufflation during protective mechanical ventilation in juvenile piglets with acute lung injury induced by endotoxin

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World Journal of Emergency Medicine 2010年第1期1卷 59-64页

作者： Zhong-liang Guo Tao Ren Ying-yun Cai Guo-ping Lu Jing-yu Gong Yong-jic Liang Department of Respiratory Medicine East Hospital Tongji University School of Medicine Shanghai 200120 China Pediatric Department Zhongshan Hospital Fudan University Shanghai 200032 China Pediatric ICU Pediatrics Hospital Fudan University Shanghai 200032 China

BACKGROUND:Low tidal volume mechanical ventilation is difficult to correct hypoxemia, and prolonged inhalation of pure oxygen can lead to oxygen poisoning. We suggest that continuous tracheal gas insufflation (TGI) during protective mechanical ventilation could improve cardiopulmonary function in acute lung injury.;METHODS:Totally 12 healthy juvenile piglets were anesthetized and mechanically ventilated at PEEP of 2 cmH2O with a peak inspiratory pressure of 10 cmH2O. The piglets were challenged with lipopolysaccharide and randomly assigned into two groups (n=6 each group): mechanical ventilation (MV) alone and TGI with continuous airway flow 2 l/min. FIO2 was set at 0.4 to avoid oxygen toxicity and continuously monitored with an oxygen analyzer.;RESULTS:Tidal volume, ventilation efficacy index and mean airway resistant pressure were significantly improved in the TGI group (Plung compliance and mean resistance of airway between the two groups. lung histological examination showed reduced inflammation, reduced intra-alveolar and interstitial patchy hemorrhage, and homogenously expanded lungs in the TGI group.;CONCLUSIONS:Continuous TGI during MV can significantly improve gas exchange and ventilation efficacy and may provide a better treatment for acute lung injury.

关键词： Acute lung injury lung protective strategy Mechanical ventilation Tracheal gas insufflation

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