Effects of different flow patterns and end-inspiratory pause on oxygenation and ventilation in newborn piglets: an experimental studyReport as inadecuate




Effects of different flow patterns and end-inspiratory pause on oxygenation and ventilation in newborn piglets: an experimental study - Download this document for free, or read online. Document in PDF available to download.

BMC Anesthesiology

, 14:96

Airway and respiratory management

Abstract

BackgroundHistorically, the elective ventilatory flow pattern for neonates has been decelerating flow DF. Decelerating flow waveform has been suggested to improve gas exchange in the neonate when compared with square flow SF waveform by improving the ventilation perfusion. However, the superiority of DF compared with SF has not yet been demonstrated during ventilation in small infants. The aim of this study was to compare SF vs. DF, with or without end-inspiratory pause EIP, in terms of oxygenation and ventilation in an experimental model of newborn piglets.

MethodsThe lungs of 12 newborn Landrace-LargeWhite crossbred piglets were ventilated with SF, DF, SF-EIP and DF-EIP. Tidal volume VT, inspiratory to expiratory ratio I-E, respiratory rate RR, and FiO2 were keep constant during the study. In order to assure an open lung during the study while preventing alveolar collapse, a positive end-expiratory pressure PEEP of 6 cmH2O was applied after a single recruitment maneuver. Gas exchange, lung mechanics and hemodynamics were measured.

ResultsThe inspiratory flow waveform had no effect on arterial oxygenation pressure PaO2 276 vs. 278 mmHg, p = 0.77, alveolar dead space to alveolar tidal volume VDalv-VTalv 0.21 vs. 0.19 ml, p = 0.33, mean airway pressure Pawm 13.1 vs. 14.0 cmH2O, p = 0.69 and compliance Crs 3.5 vs. 3.5 ml cmH2O, p = 0.73 when comparing SF and DF. A short EIP 10% did not produce changes in the results.

ConclusionThe present study showed that there are no differences between SF, DF, SF-EIP and DF-EIP in oxygenation, ventilation, lung mechanics, or hemodynamics in this experimental model of newborn piglets with healthy lungs.

KeywordsMechanical Ventilation Pediatrics Flow waveform Oxygenation Ventilation AbbreviationsVDawAirway dead space

VDalv-VTalvAlveolar dead space to alveolar tidal volume

PaO2Arterial oxygenation pressure

VTCO2br: Amount of CO2 eliminated during one breath

ALIAcute lung injury

ARMAlveolar recruitment maneuver

CICardiac index

COCardiac output

CrsCompliance

CPAPContinuous positive airway pressure

DFDecelerating flow

EIFEnd-inspiratory flow

EIPEnd-inspiratory pause

FRCFunctional residual capacity

HRHeart rate

I-EInspiratory to expiratory ratio

MAPMean arterial pressure

MDTMean distribution time

PawmMean airway pressure

MVMechanical Ventilation

PECO2Mixed PCO2 of an expiration

PEtCO2Partial pressure of CO2 at the end of expiration

VDphysPhysiological dead space

PIPPeak inspiratory pressure

PplatPlateau pressure

PEEPPositive end-expiratory pressure

PCVPressure control ventilation

RRRespiratory rate

RMRecruitment maneuver

SDStandar deviation

SFSquared flow

VTTidal volume

VCVVolume control ventilation.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2253-14-96 contains supplementary material, which is available to authorized users.

Carlos Ferrando, Marisa García, Andrea Gutierrez, Jose A Carbonell, Gerardo Aguilar, Marina Soro and Francisco J Belda contributed equally to this work.

Download fulltext PDF



Author: Carlos Ferrando - Marisa García - Andrea Gutierrez - Jose A Carbonell - Gerardo Aguilar - Marina Soro - Francisco J Beld

Source: https://link.springer.com/







Related documents