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Gewählte Publikation:

Zobel, G; Dacar, D; Rödl, S.
Proximal and tracheal airway pressures during different modes of mechanical ventilation: an animal model study.
PEDIAT PULM 1994 18: 239-243. Doi: 10.1002/ppul.1950180408
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Führende Autor*innen der Med Uni Graz
Zobel Gerfried
Co-Autor*innen der Med Uni Graz
Dacar Drago
Roedl Siegfried
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Abstract:
OBJECTIVE: To determine the differences between the mean proximal and tracheal airway pressures during 3 different modes of mechanical ventilation (MV) in an animal model of acute cardiac failure (CF) and respiratory failure (RF). DESIGN: Prospective, randomized, cross-over design. SETTING: University research laboratory. SUBJECTS: Twelve young pigs weighing 10-16 kg. INTERVENTIONS: The experimental protocol consisted of 3 stable 30 min conditions: when ventricular and pulmonary function was normal (control), after the induction of acute cardiac failure by a beta-blocking agent and after respiratory failure induced by repeated lung lavages. Modes of MV included controlled mechanical ventilation (CMV), high-frequency oscillation (HFO), and high-frequency jet ventilation (HFJV). MEASUREMENTS AND RESULTS: The tracheal mean airway pressure (P(aw)) was measured at the distal port of the Hi-lo jet tube using an air-filled pressure transducer. The mean transpulmonary P(aw) increased significantly from 0.41 +/- 0.14 kPa during the control period to 1.15 +/- 0.17 kPa (P < 0.0001) during the RF period. In all study periods both the proximal and tracheal P(aw) were lowest during HFJV. There was no difference between the proximal and tracheal P(aw) during CMV and HFJV throughout the protocol. In the cardiac and respiratory failure periods the proximal P(aw) (CF, 1.45 +/- 0.08 kPa; RF, 3.13 +/- 0.27 kPa) was significantly higher than the tracheal P(aw) (CF, 1.04 +/- 0.09 kPa, P < 0.01; RF, 2.18 +/- 0.3 kPa, P < 0.01) with HFO. When ventilated by HFO, the mean external oscillatory amplitude was 4.33 +/- 0.14 kPa and the intratracheal oscillatory amplitude was only 0.49 +/- 0.06 kPa (P < 0.0001). CONCLUSION: HFJV provides adequate respiratory support at lower P(aw) than CMV and HFO. Proximal P(aw) closely reflects tracheal P(aw) during CMV and HFJV. However, with HFO great pressure differences between the proximal and tracheal airways are evident. Therefore, additional intratracheal airway pressure monitoring seems to be very useful for optimizing ventilator settings during HFO.
Find related publications in this database (using NLM MeSH Indexing)
Acute Disease -
Animals -
Blood Gas Analysis -
Cardiac Output, Low - blood
Cross-Over Studies - blood
Female - blood
High-Frequency Jet Ventilation - blood
High-Frequency Ventilation - blood
Male - blood
Oxygen Consumption - blood
Pressure - blood
Prospective Studies - blood
Pulmonary Ventilation - physiology
Random Allocation - physiology
Research Support, Non-U.S. Gov't - physiology
Respiration, Artificial - methods
Respiratory Insufficiency - blood
Swine - blood
Trachea - physiopathology

Find related publications in this database (Keywords)
High Frequency Jet Ventilation
High Frequency Oscillation
Conventional Mechanical Ventilation
Mean Airway Pressure
Cardiac Failure
Respiratory Failure
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