Under open lung conditions inverse ratio ventilation causes intrinsic PEEP and hemodynamic impairment.

Abstract:

:Inverse ratio ventilation (IRV) is commonly used in clinical practice. Several studies have used IRV in order to recruit collapsed alveoli. In a randomised trial in twelve surfactant depleted piglets, the lungs were ventilated with sufficient positive end-expiratory pressure (PEEP) to prevent end-expiratory collapse, and the effects of increased inspiration-to-expiration (I:E ratio) were evaluated. Pressure regulated ventilation (with I:E of 1:1, constant tidal volume and decelerating inspiratory flow) was used at 30 breaths per minute (bpm). I:E ratios of 1.5:1, 2.3:1 and 4:1 were applied sequentially. When the I:E ratio was increased, external PEEP had to be reduced in order to keep total PEEP constant. Functional residual capacity, airway pressures, gas exchange, extrathermal volume and hemodynamics were measured. With I:E ratios above 2:1 intrinsic PEEP was generated and with concomitant decrease in cardiac index. PaO2 was not affected, but oxygen delivery was reduced. It is concluded that I:E ratios of 2:1, or above, generate increased intrinsic PEEP with compromised hemodynamics.

journal_name

Ups J Med Sci

authors

Markström AM,Lichtwarck-Aschoff M,Hedlund AJ,Nordgren KA,Sjöstrand UH

doi

10.3109/03009739609178925

subject

Has Abstract

pub_date

1996-01-01 00:00:00

pages

257-71

issue

3

eissn

0300-9734

issn

2000-1967

journal_volume

101

pub_type

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