It has been shown that apneic oxygenation can be safely performed for many days when metabolic carbon dioxide is removed by an extracorporeal membrane lung, and 100% oxygen is supplied directly into the trachea to keep the intrapulmonary pressure at 5 cm. H2O. The study was designed to find "best intrapulmonary pressure (IP)", analogous to "best PEEP" during continuous positive pressure ventilation. In the present study we have shown that when IP was progressively raised from 5cm H2O to 20 cm H2O the PaO2 rose significantly due to progressive decrease in QVA/Q. A linear positive correlation was found between CO and QVA/Q. There was a negative correlation between QVA/Q and FRC. Total static lung compliance and FRC increased significantly at 15--20 cm H2O IP. There was no significant change in urinary flow, urea and creatinine clearances. We conclude that in apneic oxygenation a more "optimal IP" is attained at an IP pressure of 20 cm H2O than at 5 cm H2O.
|Titolo:||Hemodynamic, mechanical and renal effects during "apneic oxygenation" with extracorporeal carbon dioxide removal, at different levels of intrapulmonary pressure in lambs|
GATTINONI, LUCIANO (Primo)
IAPICHINO, GAETANO (Secondo)
|Parole Chiave:||Animals ; blood pressure ; functional residual capacity ; sheep ; hemodynamics ; lung compliance ; oxygenators membrane ; oxygen ; extracorporeal circulation ; oxygen consumption ; lung ; kidney ; positive-pressure respiration ; pressure ; carbon dioxide|
|Settore Scientifico Disciplinare:||Settore MED/41 - Anestesiologia|
|Data di pubblicazione:||set-1979|
|Appare nelle tipologie:||01 - Articolo su periodico|