Inhibition of breathing after surfactant depletion is achieved at a higher arterial PCO2 during ventilation with liquid than with gas

Esther Rieger-Fackeldey,Andreas Schulze,Gunnar Sedin,Anders Jonzon,Richard Sindelar

doi:10.1186/1465-9921-6-24

Esther Rieger-Fackeldey, Andreas Schulze + Show 3 more

Open Access

https://doi.org/10.1186/1465-9921-6-24

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Abstract

BackgroundInhibition of phrenic nerve activity (PNA) can be achieved when alveolar ventilation is adequate and when stretching of lung tissue stimulates mechanoreceptors to inhibit inspiratory activity. During mechanical ventilation under different lung conditions, inhibition of PNA can provide a physiological setting at which ventilatory parameters can be compared and related to arterial blood gases and pH.ObjectiveTo study lung mechanics and gas exchange at inhibition of PNA during controlled gas ventilation (GV) and during partial liquid ventilation (PLV) before and after lung lavage.MethodsNine anaesthetised, mechanically ventilated young cats (age 3.8 ± 0.5 months, weight 2.3 ± 0.1 kg) (mean ± SD) were studied with stepwise increases in peak inspiratory pressure (PIP) until total inhibition of PNA was attained before lavage (with GV) and after lavage (GV and PLV). Tidal volume (Vt), PIP, oesophageal pressure and arterial blood gases were measured at inhibition of PNA. One way repeated measures analysis of variance and Student Newman Keuls-tests were used for statistical analysis.ResultsDuring GV, inhibition of PNA occurred at lower PIP, transpulmonary pressure (Ptp) and Vt before than after lung lavage. After lavage, inhibition of inspiratory activity was achieved at the same PIP, Ptp and Vt during GV and PLV, but occurred at a higher PaCO2 during PLV. After lavage compliance at inhibition was almost the same during GV and PLV and resistance was lower during GV than during PLV.ConclusionInhibition of inspiratory activity occurs at a higher PaCO2 during PLV than during GV in cats with surfactant-depleted lungs. This could indicate that PLV induces better recruitment of mechanoreceptors than GV.

Highlights

Inhibition of phrenic nerve activity (PNA) can be achieved when alveolar ventilation is adequate and when stretching of lung tissue stimulates mechanoreceptors to inhibit inspiratory activity
Ventilatory parameters and lung mechanics Inhibition of PNA occurred at a lower peak inspiratory pressure (PIP) (Table 1), a lower Ptp and lower tidal volumes (Table 1 and Fig. 2) before lavage than after lavage
This study shows that in cats ventilated with gas, inspiratory activity is inhibited at higher peak airway pressures and tidal volumes after lung lavage than before

Summary

Introduction

Inhibition of phrenic nerve activity (PNA) can be achieved when alveolar ventilation is adequate and when stretching of lung tissue stimulates mechanoreceptors to inhibit inspiratory activity. During mechanical ventilation under different lung conditions, inhibition of PNA can provide a physiological setting at which ventilatory parameters can be compared and related to arterial blood gases and pH. An increase in tidal volume and flow rate during mechanical ventilation with gas results in a decrease in magnitude or duration of the phrenic nerve signal [8,9], with absence of that response after vagotomy [8]. To achieve inhibition of phrenic nerve activity (PNA) during ventilation with air at lower ventilatory frequencies than 60, a lower arterial PCO2 and a higher pH will be needed [11]

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