Effects on lung stress of position and different doses of perfluorocarbon in a model of ARDS

Josefina López-Aguilar; Umberto Lucangelo; Guillermo M. Albaiceta; Avi Nahum; Gastón Murias; Rosario Cañizares; Joan Carles Oliva; Pablo V. Romero; Lluís Blanch

doi:10.1016/j.resp.2015.01.016

Effects on lung stress of position and different doses of perfluorocarbon in a model of ARDS

Josefina López-Aguilar, Umberto Lucangelo, Guillermo M. Albaiceta, Avi Nahum, Gastón Murias, Rosario Cañizares, Joan Carles Oliva, Pablo V. Romero, Lluís Blanch

Research output: Contribution to journal › Article › Research › peer-review

4 Citations (Scopus)

Abstract

© 2015 Elsevier B.V. We determined whether the combination of low dose partial liquid ventilation (PLV) with perfluorocarbons (PFC) and prone positioning improved lung function while inducing minimal stress. Eighteen pigs with acute lung injury were assigned to conventional mechanical ventilation (CMV) or PLV (5 or 10. ml/kg of PFC). Positive end-expiratory pressure (PEEP) trials in supine and prone positions were performed. Data were analyzed by a multivariate polynomial regression model. The interplay between PLV and position depended on the PEEP level. In supine PLV dampened the stress induced by increased PEEP during the trial. The PFC dose of 5. ml/kg was more effective than the dose 10. ml/kg. This effect was not observed in prone. Oxygenation was significantly higher in prone than in supine position mainly at lower levels of PEEP. In conclusion, MV settings should take both gas exchange and stress/strain into account. When protective CMV fails, rescue strategies combining prone positioning and PLV with optimal PEEP should improve gas exchange with minimal stress.

Original language	English
Pages (from-to)	30-37
Journal	Respiratory Physiology and Neurobiology
Volume	210
DOIs	https://doi.org/10.1016/j.resp.2015.01.016
Publication status	Published - 1 May 2015

Keywords

ARDS
Lung recruitment
Partial liquid ventilation
Perfluorocarbon
Prone
Stress

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@article{8ef8bf8b4173473385bbebad1cc15f52,

title = "Effects on lung stress of position and different doses of perfluorocarbon in a model of ARDS",

abstract = "{\textcopyright} 2015 Elsevier B.V. We determined whether the combination of low dose partial liquid ventilation (PLV) with perfluorocarbons (PFC) and prone positioning improved lung function while inducing minimal stress. Eighteen pigs with acute lung injury were assigned to conventional mechanical ventilation (CMV) or PLV (5 or 10. ml/kg of PFC). Positive end-expiratory pressure (PEEP) trials in supine and prone positions were performed. Data were analyzed by a multivariate polynomial regression model. The interplay between PLV and position depended on the PEEP level. In supine PLV dampened the stress induced by increased PEEP during the trial. The PFC dose of 5. ml/kg was more effective than the dose 10. ml/kg. This effect was not observed in prone. Oxygenation was significantly higher in prone than in supine position mainly at lower levels of PEEP. In conclusion, MV settings should take both gas exchange and stress/strain into account. When protective CMV fails, rescue strategies combining prone positioning and PLV with optimal PEEP should improve gas exchange with minimal stress.",

keywords = "ARDS, Lung recruitment, Partial liquid ventilation, Perfluorocarbon, Prone, Stress",

author = "Josefina L{\'o}pez-Aguilar and Umberto Lucangelo and Albaiceta, {Guillermo M.} and Avi Nahum and Gast{\'o}n Murias and Rosario Ca{\~n}izares and Oliva, {Joan Carles} and Romero, {Pablo V.} and Llu{\'i}s Blanch",

year = "2015",

month = may,

day = "1",

doi = "10.1016/j.resp.2015.01.016",

language = "English",

volume = "210",

pages = "30--37",

journal = "Respiratory Physiology and Neurobiology",

issn = "1569-9048",

}

Effects on lung stress of position and different doses of perfluorocarbon in a model of ARDS. / López-Aguilar, Josefina; Lucangelo, Umberto; Albaiceta, Guillermo M.; Nahum, Avi; Murias, Gastón; Cañizares, Rosario; Oliva, Joan Carles; Romero, Pablo V.; Blanch, Lluís.

In: Respiratory Physiology and Neurobiology, Vol. 210, 01.05.2015, p. 30-37.

Research output: Contribution to journal › Article › Research › peer-review

TY - JOUR

T1 - Effects on lung stress of position and different doses of perfluorocarbon in a model of ARDS

AU - López-Aguilar, Josefina

AU - Lucangelo, Umberto

AU - Albaiceta, Guillermo M.

AU - Nahum, Avi

AU - Murias, Gastón

AU - Cañizares, Rosario

AU - Oliva, Joan Carles

AU - Romero, Pablo V.

AU - Blanch, Lluís

PY - 2015/5/1

Y1 - 2015/5/1

N2 - © 2015 Elsevier B.V. We determined whether the combination of low dose partial liquid ventilation (PLV) with perfluorocarbons (PFC) and prone positioning improved lung function while inducing minimal stress. Eighteen pigs with acute lung injury were assigned to conventional mechanical ventilation (CMV) or PLV (5 or 10. ml/kg of PFC). Positive end-expiratory pressure (PEEP) trials in supine and prone positions were performed. Data were analyzed by a multivariate polynomial regression model. The interplay between PLV and position depended on the PEEP level. In supine PLV dampened the stress induced by increased PEEP during the trial. The PFC dose of 5. ml/kg was more effective than the dose 10. ml/kg. This effect was not observed in prone. Oxygenation was significantly higher in prone than in supine position mainly at lower levels of PEEP. In conclusion, MV settings should take both gas exchange and stress/strain into account. When protective CMV fails, rescue strategies combining prone positioning and PLV with optimal PEEP should improve gas exchange with minimal stress.

AB - © 2015 Elsevier B.V. We determined whether the combination of low dose partial liquid ventilation (PLV) with perfluorocarbons (PFC) and prone positioning improved lung function while inducing minimal stress. Eighteen pigs with acute lung injury were assigned to conventional mechanical ventilation (CMV) or PLV (5 or 10. ml/kg of PFC). Positive end-expiratory pressure (PEEP) trials in supine and prone positions were performed. Data were analyzed by a multivariate polynomial regression model. The interplay between PLV and position depended on the PEEP level. In supine PLV dampened the stress induced by increased PEEP during the trial. The PFC dose of 5. ml/kg was more effective than the dose 10. ml/kg. This effect was not observed in prone. Oxygenation was significantly higher in prone than in supine position mainly at lower levels of PEEP. In conclusion, MV settings should take both gas exchange and stress/strain into account. When protective CMV fails, rescue strategies combining prone positioning and PLV with optimal PEEP should improve gas exchange with minimal stress.

KW - ARDS

KW - Lung recruitment

KW - Partial liquid ventilation

KW - Perfluorocarbon

KW - Prone

KW - Stress

U2 - 10.1016/j.resp.2015.01.016

DO - 10.1016/j.resp.2015.01.016

M3 - Article

VL - 210

SP - 30

EP - 37

JO - Respiratory Physiology and Neurobiology

JF - Respiratory Physiology and Neurobiology

SN - 1569-9048

ER -