Please use this identifier to cite or link to this item: http://doi.org/10.25358/openscience-7838
Authors: Ziebart, Alexander
Hartmann, Erik
Thomas, Rainer
Liu, Tanghua
Duenges, Bastian
Schad, Arno
Bodenstein, Marc
Thal, Serge
David, Matthias
Title: Low tidal volume pressure support versus controlled ventilation in early experimental sepsis in pigs
Online publication date: 5-Oct-2022
Year of first publication: 2014
Language: english
Abstract: BACKGROUND In moderate acute respiratory distress syndrome (ARDS) several studies support the usage of assisted spontaneous breathing modes. Only limited data, however, focus on the application in systemic sepsis and developing lung injury. The present study examines the effects of immediate initiation of pressure support ventilation (PSV) in a model of sepsis-induced ARDS. METHODS 18 anesthetized pigs received a two-staged continuous lipopolysaccharide infusion to induce lung injury. The animals were randomly assigned to PSV or volume controlled (VCV) lung protective ventilation (tidal volume each 6 ml kg-1, n = 2x9) over six hours. Gas exchange parameters, hemodynamics, systemic inflammation, and ventilation distribution by multiple inert gas elimination and electrical impedance tomography were assessed. The post mortem analysis included histopathological scoring, wet to dry ratio, and alveolar protein content. RESULTS Within six hours both groups developed a mild to moderate ARDS with comparable systemic inflammatory response and without signs of improving gas exchange parameters during PSV. The PSV group showed signs of more homogenous ventilation distribution by electrical impedance tomography, but only slightly less hyperinflated lung compartments by multiple inert gas elimination. Post mortem and histopathological assessment yielded no significant intergroup differences. CONCLUSIONS In a porcine model of sepsis-induced mild ARDS immediate PSV was not superior to VCV. This contrasts with several experimental studies from non-septic mild to moderate ARDS. The present study therefore assumes that not only severity, but also etiology of lung injury considerably influences the response to early initiation of PSV.
DDC: 610 Medizin
610 Medical sciences
Institution: Johannes Gutenberg-Universität Mainz
Department: FB 04 Medizin
Place: Mainz
ROR: https://ror.org/023b0x485
DOI: http://doi.org/10.25358/openscience-7838
Version: Published version
Publication type: Zeitschriftenaufsatz
License: CC BY
Information on rights of use: https://creativecommons.org/licenses/by/4.0/
Journal: Respiratory research
15
Pages or article number: Art. 101
Publisher: Biomed Central
Publisher place: London
Issue date: 2014
ISSN: 1465-993X
1465-9921
Publisher URL: http://dx.doi.org/10.1186/s12931-014-0101-6
Publisher DOI: 10.1186/s12931-014-0101-6
Appears in collections:DFG-OA-Publizieren (2012 - 2017)

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