Effects of Spontaneous Breathing During Airway Pressure Release Ventilation on Respiratory Work and Muscle Blood Flow in Experimental Lung Injury

CHEST Journal ◽  
2005 ◽  
Vol 128 (4) ◽  
pp. 2991-2998 ◽  
Author(s):  
Rudolf Hering ◽  
Jörg Zinserling ◽  
Hermann Wrigge ◽  
Dirk Varelmann ◽  
Andreas Berg ◽  
...  
Keyword(s):  
Blood Flow ◽  
Lung Injury ◽  
Spontaneous Breathing ◽  
Airway Pressure ◽  
Muscle Blood Flow ◽  
Airway Pressure Release Ventilation ◽  
Pressure Release ◽  
Pressure Release Ventilation

Effects of Spontaneous Breathing during Airway Pressure Release Ventilation on Intestinal Blood Flow in Experimental Lung Injury

2003 ◽  
Vol 99 (5) ◽  
pp. 1137-1144 ◽  
Author(s):  
Rudolf Hering ◽  
Andreas Viehöfer ◽  
Jörg Zinserling ◽  
Hermann Wrigge ◽  
Stefan Kreyer ◽  
...  
Keyword(s):  
Blood Flow ◽  
Lung Injury ◽  
Spontaneous Breathing ◽  
Airway Pressure ◽  
Airway Pressure Release Ventilation ◽  
Intestinal Blood Flow ◽  
Systemic Hemodynamics ◽  
Blood Flows ◽  
Pressure Release ◽  
Pressure Release Ventilation

Background In critical illness, the gut is susceptible to hypoperfusion and hypoxia. Positive-pressure ventilation can affect systemic hemodynamics and regional blood flow distribution, with potentially deleterious effects on the intestinal circulation. The authors hypothesized that spontaneous breathing (SB) with airway pressure release ventilation (APRV) provides better systemic and intestinal blood flow than APRV without SB. Methods Twelve pigs with oleic acid-induced lung injury received APRV with and without SB. When SB was abolished, either the tidal volume or the ventilator rate was increased to maintain pH and arterial carbon dioxide tension constant as compared to APRV with SB. Systemic hemodynamics were determined by double indicator dilution. Blood flow to the intestinal mucosa-submucosa and muscularis-serosa was measured using colored microspheres. Results Systemic blood flow increased during APRV with SB. During APRV with SB, mucosal-submucosal blood flow (ml. g-1. min-1) was 0.39 +/- 0.21 in the stomach, 0.76 +/- 0.35 in the duodenum, 0.71 +/- 0.35 in the jejunum, 0.71 +/- 0.59 in the ileum, and 0.63 +/- 0.21 in the colon. During APRV without SB and high tidal volumes, it decreased to 0.19 +/- 0.03 in the stomach, 0.42 +/- 0.21 in the duodenum, 0.37 +/- 0.10 in the jejunum, 0.3 +/- 0.14 in the ileum, and 0.41 +/- 0.14 in the colon (P < 0.001, respectively). During APRV without SB and low tidal volumes, the respective mucosal-submucosal blood flows decreased to 0.24 +/- 0.10 (P < 0.01), 0.54 +/- 0.21 (P < 0.05), 0.48 +/- 0.17 (P < 0.01), 0.43 +/- 0.21 (P < 0.01), and 0.50 +/- 0.17 (P < 0.001) as compared to APRV with SB. Muscularis-serosal perfusion decreased during full ventilatory support with high tidal volumes in comparison with APRV with SB. Conclusion Maintaining SB during APRV was associated with better systemic and intestinal blood flows. Improvements were more pronounced in the mucosal-submucosal layer.

Spontaneous breathing during airway pressure release ventilation in experimental lung injury: effects on hepatic blood flow

2007 ◽  
Vol 34 (3) ◽  
pp. 523-527 ◽  
Author(s):  
Rudolf Hering ◽  
Jens Christopher Bolten ◽  
Stefan Kreyer ◽  
Andreas Berg ◽  
Hermann Wrigge ◽  
...  
Keyword(s):  
Blood Flow ◽  
Lung Injury ◽  
Hepatic Blood Flow ◽  
Spontaneous Breathing ◽  
Airway Pressure ◽  
Airway Pressure Release Ventilation ◽  
Pressure Release ◽  
Pressure Release Ventilation

AIRWAY PRESSURE RELEASE VENTILATION (APRV) IN A PEDIATRIC ACUTE LUNG INJURY MODEL

1990 ◽  
Vol 18 (Supplement) ◽  
pp. S231 ◽  
Author(s):  
Lynn D. Martin ◽  
Anthony L. Bilenki ◽  
James F. Rafferty ◽  
Randall C. Wetzel
Keyword(s):  
Acute Lung Injury ◽  
Lung Injury ◽  
Airway Pressure ◽  
Airway Pressure Release Ventilation ◽  
Pressure Release ◽  
Injury Model ◽  
Lung Injury Model ◽  
Pressure Release Ventilation

Airway pressure release ventilation improves pulmonary blood flow in infants after cardiac surgery*

2011 ◽  
Vol 39 (12) ◽  
pp. 2599-2604 ◽  
Author(s):  
Mark A. Walsh ◽  
Michele Merat ◽  
Gustavo La Rotta ◽  
Pretha Joshi ◽  
Vinay Joshi ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cardiac Surgery ◽  
Airway Pressure ◽  
Pulmonary Blood Flow ◽  
Airway Pressure Release Ventilation ◽  
Pressure Release ◽  
Pressure Release Ventilation
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