دورية أكاديمية
أعرض في EDS

Differential Effects of Intra-Abdominal Hypertension and ARDS on Respiratory Mechanics in a Porcine Model.

التفاصيل البيبلوغرافية
العنوان: Differential Effects of Intra-Abdominal Hypertension and ARDS on Respiratory Mechanics in a Porcine Model.
المؤلفون: Seybold B; Department of Anesthesiology, Medical Faculty, Heidelberg University Hospital, University Heidelberg, 69120 Heidelberg, Germany., Deutsch AM; Department of Anesthesiology, Medical Faculty, Heidelberg University Hospital, University Heidelberg, 69120 Heidelberg, Germany.; Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Vivantes Klinikum im Friedrichshain, 10249 Berlin, Germany., Deutsch BL; Department of Anesthesiology, Medical Faculty, Heidelberg University Hospital, University Heidelberg, 69120 Heidelberg, Germany.; Department of Anesthesiology, Intensive Care and Emergency Medicine, Asklepios Klinik Wandsbek, 22043 Hamburg, Germany., Simeliunas E; Department of Anesthesiology, Medical Faculty, Heidelberg University Hospital, University Heidelberg, 69120 Heidelberg, Germany.; Department of Anesthesiology and Intensive Care Medicine, Bürgerspital Solothurn, 4500 Solothurn, Switzerland., Weigand MA; Department of Anesthesiology, Medical Faculty, Heidelberg University Hospital, University Heidelberg, 69120 Heidelberg, Germany.; German Center for Lung Research (DZL), Translational Lung Research Center Heidelberg (TLRC), 69120 Heidelberg, Germany., Fiedler-Kalenka MO; Department of Anesthesiology, Medical Faculty, Heidelberg University Hospital, University Heidelberg, 69120 Heidelberg, Germany.; German Center for Lung Research (DZL), Translational Lung Research Center Heidelberg (TLRC), 69120 Heidelberg, Germany., Kalenka A; Department of Anesthesiology, Medical Faculty, Heidelberg University Hospital, University Heidelberg, 69120 Heidelberg, Germany.; Hospital Bergstrasse, 64646 Heppenheim, Germany.
المصدر: Medicina (Kaunas, Lithuania) [Medicina (Kaunas)] 2024 May 22; Vol. 60 (6). Date of Electronic Publication: 2024 May 22.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: MDPI Country of Publication: Switzerland NLM ID: 9425208 Publication Model: Electronic Cited Medium: Internet ISSN: 1648-9144 (Electronic) Linking ISSN: 1010660X NLM ISO Abbreviation: Medicina (Kaunas) Subsets: MEDLINE
أسماء مطبوعة: Publication: 2018- : Basel, Switzerland : MDPI
Original Publication: Kaunas : Lietuvos gydytojų sąjunga
مواضيع طبية MeSH: Respiratory Distress Syndrome*/physiopathology , Intra-Abdominal Hypertension*/physiopathology , Intra-Abdominal Hypertension*/complications , Respiratory Mechanics*/physiology , Disease Models, Animal*, Animals ; Swine ; Respiration, Artificial/adverse effects ; Respiration, Artificial/methods ; Prospective Studies
مستخلص: Background and Objectives : Intra-abdominal hypertension (IAH) and acute respiratory distress syndrome (ARDS) are common concerns in intensive care unit patients with acute respiratory failure (ARF). Although both conditions lead to impairment of global respiratory parameters, their underlying mechanisms differ substantially. Therefore, a separate assessment of the different respiratory compartments should reveal differences in respiratory mechanics. Materials and Methods : We prospectively investigated alterations in lung and chest wall mechanics in 18 mechanically ventilated pigs exposed to varying levels of intra-abdominal pressures (IAP) and ARDS. The animals were divided into three groups: group A (IAP 10 mmHg, no ARDS), B (IAP 20 mmHg, no ARDS), and C (IAP 10 mmHg, with ARDS). Following induction of IAP (by inflating an intra-abdominal balloon) and ARDS (by saline lung lavage and injurious ventilation), respiratory mechanics were monitored for six hours. Statistical analysis was performed using one-way ANOVA to compare the alterations within each group. Results : After six hours of ventilation, end-expiratory lung volume (EELV) decreased across all groups, while airway and thoracic pressures increased. Significant differences were noted between group (B) and (C) regarding alterations in transpulmonary pressure (TPP) (2.7 ± 0.6 vs. 11.3 ± 2.1 cmH 2 O, p < 0.001), elastance of the lung (E L ) (8.9 ± 1.9 vs. 29.9 ± 5.9 cmH 2 O/mL, p = 0.003), and elastance of the chest wall (E CW ) (32.8 ± 3.2 vs. 4.4 ± 1.8 cmH 2 O/mL, p < 0.001). However, global respiratory parameters such as EELV/kg bodyweight (-6.1 ± 1.3 vs. -11.0 ± 2.5 mL/kg), driving pressure (12.5 ± 0.9 vs. 13.2 ± 2.3 cmH 2 O), and compliance of the respiratory system (-21.7 ± 2.8 vs. -19.5 ± 3.4 mL/cmH 2 O) did not show significant differences among the groups. Conclusions : Separate measurements of lung and chest wall mechanics in pigs with IAH or ARDS reveals significant differences in TPP, E L , and E CW , whereas global respiratory parameters do not differ significantly. Therefore, assessing the compartments of the respiratory system separately could aid in identifying the underlying cause of ARF.
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فهرسة مساهمة: Keywords: acute respiratory distress syndrome; compliance; elastance; intra-abdominal hypertension; respiratory mechanics; strain; transpulmonary pressure
تواريخ الأحداث: Date Created: 20240627 Date Completed: 20240627 Latest Revision: 20240629
رمز التحديث: 20240629
مُعرف محوري في PubMed: PMC11205316
DOI: 10.3390/medicina60060843
PMID: 38929460
قاعدة البيانات: MEDLINE
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