Mechanical power thresholds during mechanical ventilation: an experimental study Journal Article uri icon
Overview
abstract
  • The extent of ventilator-induced lung injury may be related to the intensity of mechanical ventilation--expressed as mechanical power. In the present study, we investigated whether there is a safe threshold, below which lung damage is absent. Three groups of six healthy pigs (29.5聽卤聽2.5聽kg) were ventilated prone for 48聽h at mechanical power of 3, 7, or 12聽J/min. Strain never exceeded 1.0. PEEP was set at 4聽cmH(2) O. Lung volumes were measured every 12聽h; respiratory, hemodynamics, and gas exchange variables every 6. End-experiment histological findings were compared with a control group of eight pigs which did not undergo mechanical ventilation. Functional residual capacity decreased by 10.4% 卤聽10.6% and 8.1%聽卤聽12.1% in the 7聽J and 12聽J groups (p聽=聽0.017, p聽<聽0.001) but not in the 3聽J group (+1.7%聽卤聽17.7%, p聽=聽0.941). In 3聽J group, lung elastance, PaO(2) and PaCO(2) were worse compared to 7聽J and 12聽J groups (all p聽<聽0.001), due to lower ventilation-perfusion ratio (0.54聽卤聽0.13, 1.00聽卤聽0.25, 1.78聽卤聽0.36 respectively, p聽<聽0.001). The lung weight was lower (p聽<聽0.001) in the controls (6.56聽卤聽0.90聽g/kg) compared to 3, 7, and 12聽J groups (12.9聽卤聽3.0, 16.5聽卤聽2.9, and 15.0聽卤聽4.1聽g/kg, respectively). The wet-to-dry ratio was 5.38聽卤聽0.26 in controls, 5.73聽卤聽0.52 in 3聽J, 5.99聽卤聽0.38 in 7聽J, and 6.13聽卤聽0.59 in 12聽J group (p聽=聽0.03). Vascular congestion was more extensive in the 7聽J and 12聽J compared to 3聽J and control groups. Mechanical ventilation (with anesthesia/paralysis) increase lung weight, and worsen lung histology, regardless of the mechanical power. Ventilating at 3聽J/min led to better anatomical variables than at 7 and 12聽J/min but worsened the physiological values.

  • Link to Article
  • publication date
  • 2022
  • published in
    Research
    keywords
  • Animal Studies
  • Critical Care
  • Injuries
  • Lung
  • Respiration, Artificial
  • Additional Document Info
    volume
  • 10
  • issue
  • 6