Effects of helium-oxygen on respiratory mechanics, gas exchange, and ventilation-perfusion relationships in a porcine model of stable methacholine-induced bronchospasm.

Détails

ID Serval
serval:BIB_8E213805042B
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Effects of helium-oxygen on respiratory mechanics, gas exchange, and ventilation-perfusion relationships in a porcine model of stable methacholine-induced bronchospasm.
Périodique
Intensive Care Medicine
Auteur(s)
Watremez C., Liistro G., deKock M., Roeseler J., Clerbaux T., Detry B., Reynaert M., Gianello P., Jolliet P.
ISSN
0342-4642 (Print)
ISSN-L
0342-4642
Statut éditorial
Publié
Date de publication
2003
Peer-reviewed
Oui
Volume
29
Numéro
9
Pages
1560-1566
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Résumé
OBJECTIVE: To explore the consequences of helium/oxygen (He/O(2)) inhalation on respiratory mechanics, gas exchange, and ventilation-perfusion (VA/Q) relationships in an animal model of severe induced bronchospasm during mechanical ventilation.
DESIGN: Prospective, interventional study.
SETTING: Experimental animal laboratory, university hospital.
INTERVENTIONS: Seven piglets were anesthetized, paralyzed, and mechanically ventilated, with all ventilator settings remaining constant throughout the protocol. Acute stable bronchospasm was obtained through continuous aerosolization of methacholine. Once steady-state was achieved, the animals successively breathed air/O(2) and He/O(2) (FIO(2) 0.3), or inversely, in random order. Measurements were taken at baseline, during bronchospasm, and after 30 min of He/O(2) inhalation.
RESULTS: Bronchospasm increased lung peak inspiratory pressure (49+/-6.9 vs 18+/-1 cm H(2)O, P<0.001), lung resistance (22.7+/-1.5 vs 6.8+/-1.5 cm H(2)O x l(-1).s, P<0.001), dynamic elastance (76+/-11.2 vs 22.8+/-4.1 cm H(2)O x l(-1), P<0.001), and work of breathing (1.51+/-0.26 vs 0.47+/-0.08, P<0.001). Arterial pH decreased (7.47+/-0.06 vs 7.32+/-0.06, P<0.001), PaCO(2) increased, and PaO(2) decreased. Multiple inert gas elimination showed an absence of shunt, substantial increases in perfusion to low VA/Q regions, and dispersion of VA/Q distribution. He/O(2) reduced lung resistance and work of breathing, and worsened hypercapnia and respiratory acidosis.
CONCLUSIONS: In this model, while He/O(2) improved respiratory mechanics and reduced work of breathing, hypercapnia and respiratory acidosis increased. Close attention should be paid to monitoring arterial blood gases when He/O(2) is used in mechanically ventilated acute severe asthma.
Mots-clé
Acute Disease, Animals, Asthma/diagnosis, Asthma/therapy, Bronchial Spasm/diagnosis, Bronchial Spasm/therapy, Bronchoconstrictor Agents/administration & dosage, Disease Models, Animal, Helium/administration & dosage, Methacholine Chloride/diagnostic use, Oxygen Inhalation Therapy/methods, Pulmonary Gas Exchange, Respiration, Artificial, Respiratory Mechanics, Swine, Treatment Outcome, Ventilation-Perfusion Ratio
Pubmed
Web of science
Création de la notice
27/06/2013 15:39
Dernière modification de la notice
03/03/2018 19:17
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