Regional distribution of static lung strain induced by positive-end expiratory pressure (PEEP) in healthy, dorsally recumbent, anesthetized and mechanically ventilated dogs

2020 ◽  
Vol 47 (6) ◽  
pp. 855.e1
Author(s):  
J. Araos ◽  
T. Boullhesen-Williams ◽  
A. Perez ◽  
J. Retamal ◽  
M. Martin-Flores ◽  
...  
Keyword(s):  
Regional Distribution ◽  
Positive End Expiratory Pressure ◽  
Mechanically Ventilated ◽  
Lung Strain

scholarly journals Is There an Optimal Positive End-expiratory Pressure to Measure the Internal Jugular Vein Collapsibility Index? A Pilot Study in Mechanically Ventilated Patients

2021 ◽  
Author(s):  
Alireza Zeraatchi ◽  
Taraneh Naghibi ◽  
Hamid Kafili ◽  
Somayeh Abdollahi Sabet
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Positive End Expiratory Pressure ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Collapsibility Index ◽  
Vein Diameter ◽  
Ventilated Patients

Background: Hemodynamic monitoring its early stabilization is very important in critically ill patients. Evaluating the Internal jugular vein diameter during respiratory cycles by the means of Point-of care ultrasound provides an important, easily available and precise index for monitoring hemodynamic status; a new method which is called Internal Jugular Vein Collapsibility Index (IJV-CI). Any events that alters intrathoracic volumes and pressures may affect this index. In this study we investigate the effects of various levels of positive end-expiratory pressure on this index. Methods: Thirty mechanically ventilated patients were studied. We used three different PEEP levels (0, 5 and 10 cmH2o) and point-of-care ultrasound evaluation of IJV (Internal Jugular Vein) diameter to determine the IJV-CI. The analysis were performed using SPSS V.25.0. Results: Patients were included men (76.6%) and women (33.3%). The mean age of patients was 39.65±3.4 for men and 42.71± 9.34 for women. The IJV-CI were 20.71±11.77 and 24.25±11.46 in PEEP=0 and PEEP=10 cmH20 groups respectively. In 5cmH20-PEEP group median and interquartile range were 16.45(14.8). The IJV-CI in three different PEEP levels were not statistically significantly different. Conclusion: According to the finding of this study, we found no evidence of an optimal PEEP level to measure The IJV-CI.

Positive end-expiratory pressure enhances development of a functional residual capacity in preterm rabbits ventilated from birth

2009 ◽  
Vol 106 (5) ◽  
pp. 1487-1493 ◽  
Author(s):  
Melissa L. Siew ◽  
Arjan B. te Pas ◽  
Megan J. Wallace ◽  
Marcus J. Kitchen ◽  
Robert A. Lewis ◽  
...  
Keyword(s):  
Functional Residual Capacity ◽  
Positive End Expiratory Pressure ◽  
Mechanically Ventilated ◽  
Very Preterm ◽  
Lung Aeration ◽  
X Ray Imaging ◽  
Airway Collapse ◽  
Distal Airway ◽  
Dead Space Volume ◽  
Residual Capacity

The factors regulating lung aeration and the initiation of pulmonary gas exchange at birth are largely unknown, particularly in infants born very preterm. As hydrostatic pressure gradients may play a role, we have examined the effect of a positive end-expiratory pressure (PEEP) on the spatial and temporal pattern of lung aeration in preterm rabbit pups mechanically ventilated from birth using simultaneous phase-contrast X-ray imaging and plethysmography. Preterm rabbit pups were delivered by caesarean section at 28 days of gestational age, anesthetized, intubated, and placed within a water-filled plethysmograph (head out). Pups were imaged as they were mechanically ventilated from birth with a PEEP of either 0 cmH2O or 5 cmH2O. The peak inflation pressure was held constant at 35 cmH2O. Without PEEP, gas only entered into the distal airways during inflation. The distal airways collapsed during expiration, and, as a result, the functional residual capacity (FRC) did not increase above the lung's anatomic dead space volume (2.5 ± 0.8 ml/kg). In contrast, ventilation with 5-cmH2O PEEP gradually increased aeration of the distal airways, which did not collapse at end expiration. The FRC achieved in pups ventilated with PEEP (19.9 ± 3.2 ml/kg) was significantly greater than in pups ventilated without PEEP (−2.3 ± 3.5 ml/kg). PEEP greatly facilitates aeration of the distal airways and the accumulation of FRC and prevents distal airway collapse at end expiration in very preterm rabbit pups mechanically ventilated from birth.

scholarly journals Bronchoscopic Insufflation of Room Air for the Treatment of Lobar Atelectasis in Mechanically Ventilated Patients

1995 ◽  
Vol 23 (2) ◽  
pp. 175-177 ◽  
Author(s):  
P. V. Van Heerden ◽  
W. Jacob ◽  
P. D. Cameron ◽  
S. Webb
Keyword(s):  
Positive Pressure Ventilation ◽  
Chest Physiotherapy ◽  
Additional Benefit ◽  
Positive Pressure ◽  
Common Occurrence ◽  
Positive End Expiratory Pressure ◽  
Pulmonary Atelectasis ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Ventilated Patients

Segmental and lobar pulmonary atelectasis is a common occurrence in mechanically ventilated patients. Standard therapy for atelectasis relies on positive pressure ventilation, positive end expiratory pressure (PEEP), tracheobronchial toilet and regular chest physiotherapy. Various adjuncts to physiotherapy such as bronchoscopic clearance of secretions have not proved to be of additional benefit. Bronchoscopic clearance of secretions followed by insufflation of room air at 30 cm H2O into the atelectatic segment was employed on ten occasions in mechanically ventilated patients. Rapid re-expansion of the collapsed segment or lobe occurred in seven out of the ten treatments.

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