Abstract
To determine reciprocal and synergistic effects of acute intracranial hypertension and ARDS on pulmonary density and extravascular lung water in healthy and injured lungs. Twenty-eight mechanically ventilated pigs were randomized to four groups of seven each: control; acute intracranial hypertension (AICH); acute respiratory distress syndrome (ARDS); acute respiratory distress syndrome in combination with acute intracranial hypertension (ARDS + AICH). AICH was induced with an intracranial balloon catheter and the inflation volume was adjusted to keep intracranial pressure (ICP) at 30 40 cmH2O. ARDS was induced by oleic acid infusion. Respiratory function, hemodynamics, extravascular lung water index (ELWI) and lung density in CT were measured over a 4-h period. Lung tissue was collected and examined at the end of the experiment. Results: In both healthy and injured lungs, AICH caused increases in extravascular lung water, and lung density in CT, the extent of poorly aerated (dystelectatic) and atelectatic lung regions. Conclusions: AICH induces lung injury and also exacerbates preexisting damage. Increased extravascular lung water is an early marker.
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