Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Positive end-expiratory pressure optimization with forced oscillation technique reduces ventilator induced lung injury: a controlled experimental study in pigs with saline lavage lung injury. | Kostic et al. Critical Care 2011 15 R126 http content 15 3 R126 KS CRITICAL CARE RESEARCH Open Access Positive end-expiratory pressure optimization with forced oscillation technique reduces ventilator induced lung injury a controlled experimental study in pigs with saline lavage lung injury Peter Kostic1 Emanuela Zannin2 Marie Andersson Olerud1 Pasquale P Pompilio2 Goran Hedenstierna3 Antonio Pedotti2 Anders Larsson1 Peter Frykholm1 and Raffaele L Dellaca2 Abstract Introduction Protocols using high levels of positive end-expiratory pressure PEEP in combination with low tidal volumes have been shown to reduce mortality in patients with severe acute respiratory distress syndrome ARDS . However the optimal method for setting PEEP is yet to be defined. It has been shown that respiratory system reactance Xrs measured by the forced oscillation technique FOT at 5 Hz may be used to identify the minimal PEEP level required to maintain lung recruitment. The aim of the present study was to evaluate if using Xrs for setting PEEP would improve lung mechanics and reduce lung injury compared to an oxygenation-based approach. Methods 17 pigs in which acute lung injury ALI was induced by saline lavage were studied. Animals were randomized into two groups in the first PEEP was titrated according to Xrs FOT group in the control group PEEP was set according to the ARDSNet protocol ARDSNet group . The duration of the trial was 12 hours. In both groups recruitment maneuvers RM were performed every 2 hours increasing PEEP to 20 cmH2O. In the FOT group PEEP was titrated by monitoring Xrs while PEEP was reduced from 20 cmH2O in steps of 2 cmH2O. PEEP was considered optimal at the step before which Xrs started to decrease. Ventilatory parameters lung mechanics blood gases and hemodynamic parameters were recorded hourly. Lung injury was evaluated by histopathological analysis. Results The PEEP levels set in the FOT group were significantly higher compared to those set in the .
