29780
document
Combination of arteriovenous extracorporeal lung assist and high-frequency oscillatory ventilation in a porcine model of lavage-induced acute lung injury : a randomized controlled trial . BACKGROUND To compare the combined effects of arteriovenous extracorporeal lung assist ( AV-ECLA ) and high-frequency oscillatory ventilation ( HFOV ) on pulmonary gas exchange , hemodynamics , and respiratory parameters in a lavage-induced porcine lung injury model . METHODS A prospective , randomized animal study . Saline lung lavage was performed in 33 healthy female pigs , weighing 52 +/- 4.1 kg ( mean +/- SD ) , until the Pao2 decreased to 53 +/- 8 mm Hg . After a stabilization period of 60 minutes , the animals were randomly assigned to four groups : group 1 , pressure-controlled ventilation ( PCV ) with a tidal volume of 6 mL/kg ; group 2 , PCV with a tidal volume of 6 mL/kg and AV-ECLA ; group 3 , HFOV ; group 4 , HFOV and AV-ECLA . In groups 2 and 4 , the femoral artery and vein were cannulated and a low-resistance membrane lung was interposed . After isolated evaluation of AV-ECLA , the mean airway pressure was increased by 3 cm H2O from 16 to 34 cm H2O every 20 minutes , accompanied by blood gas analyses and measurements of respiratory and hemodynamic variables . RESULTS Only in AV-ECLA-treated animals was normocapnia achieved . No significant increase of Pao2 attributable to AV-ECLA alone was detected . Mean airway pressure augmentation resulted in a significant increase in Pao2 in all groups . Peak inspiratory pressure was significantly lower in HFOV-treated animals . CONCLUSIONS The combination of AV-ECLA and HFOV resulted in normocapnia and comparable Pao2 , although a smaller ventilator pressure amplitude was applied . Long-term animal studies are needed to assess whether this approach results in further lung protection .
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Intervention_Physical
arteriovenous extracorporeal lung assist
29782
Intervention_Physical
high-frequency oscillatory ventilation
29783
Intervention_Physical
arteriovenous extracorporeal lung assist ( AV-ECLA )
29784
Intervention_Physical
high-frequency oscillatory ventilation ( HFOV )
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Intervention_Physical
Saline lung lavage
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Intervention_Physical
pressure-controlled ventilation ( PCV )
29787
Intervention_Physical
PCV
29788
Intervention_Physical
AV-ECLA
29789
Intervention_Surgical
;
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Intervention_Physical
HFOV
29791
Intervention_Physical
HFOV and AV-ECLA
29792
Intervention_Physical
AV-ECLA
29793
Intervention_Physical
AV-ECLA-treated
29794
Intervention_Physical
AV-ECLA
29795
Intervention_Physical
AV-ECLA
29796
Intervention_Physical
HFOV
29797
Outcome_Physical
pulmonary gas exchange , hemodynamics , and respiratory parameters
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Outcome_Physical
mean airway pressure
29799
Outcome_Physical
blood gas analyses and measurements of respiratory and hemodynamic variables
29800
Outcome_Physical
normocapnia
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Outcome_Physical
Pao2 attributable
29802
Outcome_Physical
Mean airway pressure augmentation
29803
Outcome_Physical
Peak inspiratory pressure
29804
Outcome_Physical
normocapnia
29805
Outcome_Physical
Pao2
29806
Participant_Condition
lavage-induced acute lung injury
29807
Participant_Sample-size
33
29808
Participant_Sex
female