Abstract
In acute respiratory distress syndrome (ARDS), intra-abdominal hypertension (IAH) increases intra-thoracic pressures, leading atelectasis and deterioration of respiratory mechanics and gas-exchange. The optimal setting of mechanical ventilation (MV) and its impact on respiratory function and ventilator-induced lung injury (VILI) in ARDS associated with IAH needs to be better clarified. Lung-protective MV with low tidal volume (VT) and positive end-expiratory pressure (PEEP) has been recommended; however, assisted MV may be a favorable alternative to controlled MV at the early phase of ARDS, since it requires less sedation, no paralysis and is associated with better lung protection, reducing the risk of VILI. We hypothesized that pressure-support ventilation (PSV) improve pulmonary morphofunction and minimize lung injury in ARDS with IAH.
Highlights
In acute respiratory distress syndrome (ARDS), intraabdominal hypertension (IAH) increases intra-thoracic pressures, leading atelectasis and deterioration of respiratory mechanics and gas-exchange
To compare the effects of pressure-support ventilation (PSV) with protective mechanical ventilation (MV) (PCV) on arterial blood gases, lung mechanics and histology, as well as to identify biological markers of inflammation and fibrogenesis in a model of ARDS with IAH
During PCV, animals were paralyzed with pancuronium bromide
Summary
In acute respiratory distress syndrome (ARDS), intraabdominal hypertension (IAH) increases intra-thoracic pressures, leading atelectasis and deterioration of respiratory mechanics and gas-exchange. Objectives To compare the effects of PSV with protective MV (PCV) on arterial blood gases, lung mechanics and histology, as well as to identify biological markers of inflammation and fibrogenesis in a model of ARDS with IAH. Methods 24 Wistar rats (250-300 g) were submitted to the a sequence of events: 1) receive Escherichia coli lipopolysaccharide (LPS) intraperitoneally (1,000 μg); 2) waiting
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