Variations in End-Expiratory Pressure During Partial Liquid Ventilation

• Published in: Chest Vol. 117; no. 1; pp. 184 - 190
• Main Authors: Manaligod, Joel M., Bendel-Stenzel, Ellen M., Meyers, Pat A., Bing, Dennis R., Connett, John E., Mammel, Mark C.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.01.2000; American College of Chest Physicians
• Subjects: a/A = arterial/alveolar; C/kg = dynamic lung compliance perkilogram; CVP = central venous pressure; EELV = end-expiratory lungvolume; Fio2 = fraction of inspired oxygen; FRC = functional residual capacity; lung compliance; lung injury; OI = oxygenation index; Paw = mean airway pressure; PEEP = positive end-expiratorypressure; perfluorocarbon; PIP = peak inspiratory pressure; PLV = partial liquidventilation; positive end-expiratory pressure; TLV = total liquid ventilation; Ve/kg = minute ventilation per kilogram; ventilation; Vt = tidal volume; Paw = mean airway pressure; lung compliance; TLV = total liquid ventilation; Ve/kg = minute ventilation per kilogram; positive end-expiratory pressure; PLV = partial liquidventilation; Fio2 = fraction of inspired oxygen; OI = oxygenation index; ventilation; EELV = end-expiratory lungvolume; perfluorocarbon; PEEP = positive end-expiratorypressure; Vt = tidal volume; CVP = central venous pressure; PIP = peak inspiratory pressure; lung injury; a/A = arterial/alveolar; C/kg = dynamic lung compliance perkilogram; FRC = functional residual capacity
• ISSN: 0012-3692; 1931-3543
• DOI: 10.1378/chest.117.1.184

To determine the effects ofdifferent levels of positive end-expiratory pressure (PEEP) duringpartial liquid ventilation (PLV) on gas exchange, lung compliance, andend-expiratory lung volume (EELV). Prospectiveanimal study. Animal physiology researchlaboratory. Nine piglets. Animals underwent saline solution lavage toproduce lung injury. Perflubron was instilled via the endotracheal tubein a volume estimated to represent functional residual capacity. Theinitial PEEP setting was 4 cm H2O, and stepwise changes inPEEP were made. At 30-min intervals, the PEEP was increased to 8, then12, then decreased back down to 8, then 4 cm H2O. After 30 min at each level of PEEP, arterial blood gases, aortic and central venous pressures, heartrates, dynamic lung compliance, and changes in EELV were recorded.Paired t tests with Bonferroni correction were used toevaluate the data. There were no differences in heart rate or mean BPat the different PEEP levels. CO2 elimination andoxygenation improved directly with the PEEP level and mean airwaypressure (Paw). Compliance did not change with increasing PEEP, but didincrease when PEEP was lowered. EELV changes correlated directly withthe level of PEEP. As previously reportedduring gas ventilation, oxygenation and CO2 eliminationvary directly with PEEP and proximal Paw during PLV. EELV also variesdirectly with PEEP. Dynamic lung compliance, however, improved onlywhen PEEP was lowered, suggesting an alteration in the distribution ofperflubron due to changes in pressure-volumerelationships.