Effects of electrical activity of diaphragm on the titration of positive end-expiratory pressure in a model of acute respiratory distress syndrome
Wu, X-yan.; Zheng, R-qiang.; Liu, H-gen.; Huang, D-ya.; Huang, Y-zi.; Qiu, H-bo.
Zhonghua Yi Xue Za Zhi 91(43): 3086-3089
2011
ISSN/ISBN: 0376-2491 PMID: 22333066 Document Number: 648768
To explore the relationship of electrical activity of diaphragm (EAdi) and positive end-expiratory pressure (PEEP) in a rabbit model of acute respiratory distress syndrome (ARDS). The rabbit model of ARDS was induced by an intratracheal infusion of hydrochloric acid. After a sufficient amount of recruitment maneuvers (RM), the level: the PEEP levels were (10.4 ± 1.0) cm H2O in EAdi group and (9.7 ± 2.1) cm H2O in rabbits were divided into 2 groups: (1) PEEP titration with EAdi (EAdi group); (2) PEEP titration with maximum oxygenation (maximum oxygenation group). The tidal volume was 6 ml/kg in 2 groups. Pulmonary mechanics, gas exchange and hemodynamic were observed in two groups at baseline, after lung injury and ventilation 1, 2, 3 h respectively. (1) PEEP maximum oxygenation group. There was no significant difference between two groups (P > 0.05). (2) Pulmonary mechanics:there was no significant difference in peak pressure (Ppeak) and mean pressure (Pm) between two groups at ventilation 1, 2, 3 h (P > 0.05). (3) Gas exchange: at ventilation 1, 2, 3 h, the oxygenation index (PaO2/FiO2) in EAdi group was higher than that of after lung injury (P < 0.05) and there was no significant difference in PaO2/FiO2 and partial pressure of arterial carbon dioxide (PaCO2) between two groups (P > 0.05). (4) Hemodynamic: at ventilation 1, 2, 3 h, the heart rate (HR) and mean artery pressure (MAP) in EAdi group had no significant differences with baseline, after lung injury and maximum oxygenation group (P > 0.05). EAdi may be an ideal method for PEEP titration at post-RM in an ARDS model.