Pressure-regulated volume control vs. volume control ventilation in healthy and injured rabbit lung: An experimental study.

Abstract:

BACKGROUND:It is not well understood how different ventilation modes affect the regional distribution of ventilation, particularly within the injured lung. OBJECTIVES:We compared respiratory mechanics, lung aeration and regional specific ventilation ((Equation is included in full-text article.)) distributions in healthy and surfactant-depleted rabbits ventilated with pressure-regulated volume control (PRVC) mode with a decelerating inspiratory flow or with volume control (VC) mode. DESIGN:Randomised experimental study. ANIMALS AND INTERVENTIONS:New Zealand white rabbits (n = 8) were anaesthetised, paralysed and mechanically ventilated either with VC or PRVC mode (tidal volume: 7 ml kg; rate: 40 min; positive end-expiratory pressure (PEEP): 3 cmH2O), at baseline and after lung injury induced by lung lavage. MAIN OUTCOME MEASURES:Airway resistance (Raw), respiratory tissue damping (G) and elastance (H) were measured by low-frequency forced oscillations. Synchrotron radiation computed tomography during stable xenon wash-in was used to measure regional lung aeration and specific ventilation and the relative fraction of nonaerated, trapped, normally, poorly and hyperinflated lung regions. RESULTS:Lung lavage significantly elevated peak inspiratory pressure (PIP) (P < 0.001). PIP was lower on PRVC compared with VC mode (-12.7 ± 1.7%, P < 0.001). No significant differences in respiratory mechanics, regional ventilation distribution, strain or blood oxygenation could be detected between the two ventilation modes. CONCLUSION:A decelerating flow pattern (PRVC) resulted in equivalent regional ventilation distribution, respiratory mechanics and gas exchange, in both normal and mechanically heterogeneous lungs with, however, a significantly lower peak pressure. Our data suggest that the lower PIP on PRVC ventilation was because of the decelerating flow pattern rather than the ventilation distribution.

journal_name

Eur J Anaesthesiol

authors

Porra L,Bayat S,Malaspinas I,Albu G,Doras C,Broche L,Strengell S,Peták F,Habre W

doi

10.1097/EJA.0000000000000485

subject

Has Abstract

pub_date

2016-10-01 00:00:00

pages

767-75

issue

10

eissn

0265-0215

issn

1365-2346

journal_volume

33

pub_type

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