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RESEARCH PRODUCT
Pulmonary effects of expiratory-assisted small-lumen ventilation during upper airway obstruction in pigs
Arno SchadMatthias DavidJens KamufRainer ThomasAlexander ZiebartBastian DuengesTanghua LiuAndreas Garcia-bardonErik K. Hartmannsubject
Malemedicine.medical_specialtyPartial PressureAcute Lung InjurySus scrofaPulmonary effectsLumen (anatomy)Lung injuryTidal VolumemedicineAnimalsPulmonary Gas Exchangebusiness.industryHemodynamicsrespiratory systemAirway obstructionmedicine.diseaseRespiration ArtificialTension pneumothoraxrespiratory tract diseasesAirway ObstructionOxygenDisease Models AnimalAnesthesiology and Pain MedicineAnesthesiaBreathingHistopathologyTracheotomybusinessPerfusiondescription
Summary Novel devices for small-lumen ventilation may enable effective inspiration and expiratory ventilation assistance despite airway obstruction. In this study, we investigated a porcine model of complete upper airway obstruction. After ethical approval, we randomly assigned 13 anaesthetised pigs either to small-lumen ventilation following airway obstruction (n = 8) for 30 min, or to volume-controlled ventilation (sham setting, n = 5). Small-lumen ventilation enabled adequate gas exchange over 30 min. One animal died as a result of a tension pneumothorax in this setting. Redistribution of ventilation from dorsal to central compartments and significant impairment of the distribution of ventilation/perfusion occurred. Histopathology demonstrated considerable lung injury, predominantly through differences in the dorsal dependent lung regions. Small-lumen ventilation maintained adequate gas exchange in a porcine airway obstruction model. The use of this technique for 30 min by inexperienced clinicians was associated with considerable end-expiratory collapse leading to lung injury, and may also carry the risk of severe injury.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2015-04-28 | Anaesthesia |