脂多糖全身炎症实验模型中三种呼吸模式对血流动力学、肺生理学和组织学的影响

Ramón  González-Camarena, Felipe Vadillo-Ortega, Edgar Zenteno-Galindo, Claudia  Hernández-Jiménez, Matilde  Baltazares-Lipp, Luis Florentino  Vázquez-Justiniano, María T. Silva-Martínez, M. Gaxiola-Gaxiola, Rogelio  García-Torrentera, Rogelio  Jasso-Victoria, J Raúl  Olmos-Zúñiga, A. E. Guzmán-Cedillo
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引用次数: 1

摘要

. 简介:气道压力释放通气(APRV)和高频振荡通气(HFOV)模式提供肺保护,但不用于脓毒症患者。目的:比较PCV、APRV和HFOV三种模式下机械通气支持(MVS)作为唯一治疗方式对大肠杆菌脂多糖诱导全身炎症猪模型的血流动力学、气相测量、力学和肺组织学的影响。材料和方法:18头全身性炎症猪只接受MVS治疗:I组:PCV, II组:APRV, III组:HFOV。气体测量值,力学和组织学评估6小时。结果:三种通气模式改变了肺血流动力学,但维持了肺力学和气相测量值。HFOV保持稳定的全身血流动力学值和高乳酸血症(p < 0.05, ANOVA - MR),并产生较少的组织学损伤(p < 0.05, Kruskal - Wallis)。结论:APRV和HFOV两种模式作为猪大肠埃希氏杆菌LPS致脓毒症初始阶段的独特支持模式,可使猪的气、通气量维持在正常参数范围内;但是,HFOV模式有利于全身血流动力学值的恢复,并产生较小的组织损伤。
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Efecto de tres modos ventilatorios como único soporte en un modelo experimental de inflamación sistémica por lipopolisacárido sobre la hemodinamia, fisiología pulmonar e histología
. Introduction: The airway pressure release ventilation (APRV) and high frequency oscillatory ventilation (HFOV) modes provides lung protection, but is not used in patients with sepsis. Objective: Compared the effect of mechanical ventilation support (MVS) in PCV, APRV and HFOV modes as the only therapy in a pig model of systemic inflammation induced by Escherichia coli lipopolysaccharide on hemodynamics, gasometry, mechanics and lung histology. Material and methods: Eighteen pigs with systemic inflammation were treated only with MVS: group I: PCV, group II: APRV and group III: HFOV. gasometric values, mechanics and histology assessed for six hours. Results: The three ventilatory modes alter pulmonary hemodynamics, but maintain gasometry and lung mechanics values. The HFOV remain stable systemic hemodynamic values, hyperlactatemia (p < 0.05, ANOVA‑MR) and produces less histological damage (p < 0.05, Kruskal‑Wallis). Conclusions: The APRV and HFOV modes used as the unique support in the initial phases of sepsis induced with LPS of Escherichia coli in pigs, maintain the gasometric and ventilatory values within normal parameters; but, the HFOV mode favors the recovery of systemic hemodynamic values and produces less histological damage.
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