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AuthorMendler, Marc Robindc.contributor.author
Date of accession2016-03-15T09:08:58Zdc.date.accessioned
Available in OPARU since2016-03-15T09:08:58Zdc.date.available
Year of creation2013dc.date.created
AbstractBackground: Ventilation using low tidal volumes with permission of hypercapnia is recommended to protect the lung in acute respiratory distress syndrome. However, the most lung protective tidal volume in association with hypercapnia is unknown. The aim of this study was to assess the effects of different tidal volumes with associated hypercapnia on lung injury and gas exchange in a model for acute respiratory distress syndrome. Methodology/Principal findings: In this randomized controlled experiment sixty-four surfactant-depleted rabbits were exposed to 6 hours of mechanical ventilation with the following targets: Group 1: tidal volume = 8 - 10 ml/kg/PaCO2 = 40 mm Hg; Group 2: tidal volume = 4 - 5 ml/kg/PaCO2 = 80 mm Hg; Group 3: tidal volume = 3 - 4 ml/kg/PaCO2 = 120 mm Hg; Group 4: tidal volume = 2 - 3 ml/kg/PaCO2 = 160 mm Hg. Decreased wet-dry weight ratios of the lungs, lower histological lung injury scores and higher PaO2 were found in all low tidal volume/hypercapnia groups (group 2, 3, 4) as compared to the group with conventional tidal volume/normocapnia (group 1). The reduction of the tidal volume below 4 - 5 ml/kg did not enhance lung protection. However, oxygenation and lung protection were maintained at extremely low tidal volumes in association with very severe hypercapnia and no adverse hemodynamic effects were observed with this strategy. Conclusion: Ventilation with low tidal volumes and associated hypercapnia was lung protective. A tidal volume below 4 - 5 ml/kg/PaCO2 80 mm Hg with concomitant more severe hypercapnic acidosis did not increase lung protection in this surfactant deficiency model. However, even at extremely low tidal volumes in association with severe hypercapnia lung protection and oxygenation were maintained.dc.description.abstract
Languagededc.language.iso
PublisherUniversität Ulmdc.publisher
LicenseStandarddc.rights
Link to license texthttps://oparu.uni-ulm.de/xmlui/license_v3dc.rights.uri
KeywordAcute respiratory distress syndromedc.subject
KeywordLungenprotektive Beatmungsverfahrendc.subject
KeywordPermissive Hyperkapniedc.subject
Dewey Decimal GroupDDC 610 / Medicine & healthdc.subject.ddc
MeSHHypercapniadc.subject.mesh
MeSHPulmonary gas exchangedc.subject.mesh
MeSHRespiratory distress syndrome, adultdc.subject.mesh
MeSHRespiratory organs; Pathophysiologydc.subject.mesh
TitleEinfluss von permissiver Hyperkapnie auf den Gasaustausch, die Lungenschädigung und die Hämodynamik am Versuchstier mit schwerem "Acute Respiratory Distress Syndrome (ARDS)"dc.title
Resource typeDissertationdc.type
DOIhttp://dx.doi.org/10.18725/OPARU-3055dc.identifier.doi
PPN777415453dc.identifier.ppn
URNhttp://nbn-resolving.de/urn:nbn:de:bsz:289-vts-88746dc.identifier.urn
GNDARDSdc.subject.gnd
GNDHyperkapniedc.subject.gnd
FacultyMedizinische Fakultätuulm.affiliationGeneral
Date of activation2014-01-28T11:17:18Zuulm.freischaltungVTS
Peer reviewneinuulm.peerReview
Shelfmark print versionW: W-H 13.496uulm.shelfmark
DCMI TypeTextuulm.typeDCMI
VTS ID8874uulm.vtsID
CategoryPublikationenuulm.category
Bibliographyuulmuulm.bibliographie


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