Ultra-low tidal volume ventilation during cardiopulmonary resuscitation shows no mitigating effect on pulmonary end-organ damage compared to standard ventilation: insights from a porcine model
Abstract Objective This study aimed to determine whether ultra-low tidal volume ventilation (ULTVV) applied during cardiopulmonary resuscitation (CPR) compared with standard ventilation (intermittent positive pressure ventilation, IPPV) can reduce pulmonary end-organ damage in the post-resuscitation...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-11-01
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| Series: | Intensive Care Medicine Experimental |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40635-023-00568-6 |
| _version_ | 1827635832247287808 |
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| author | Katja Mohnke Philipp Conzelmann Miriam Renz Julian Riedel René Rissel Andrea Urmann Johanna Hain Bastian Duenges Alexander Ziebart Robert Ruemmler |
| author_facet | Katja Mohnke Philipp Conzelmann Miriam Renz Julian Riedel René Rissel Andrea Urmann Johanna Hain Bastian Duenges Alexander Ziebart Robert Ruemmler |
| author_sort | Katja Mohnke |
| collection | DOAJ |
| description | Abstract Objective This study aimed to determine whether ultra-low tidal volume ventilation (ULTVV) applied during cardiopulmonary resuscitation (CPR) compared with standard ventilation (intermittent positive pressure ventilation, IPPV) can reduce pulmonary end-organ damage in the post-resuscitation period. Methods A prospective, randomized trial was conducted using a porcine model (n = 45). The animals were divided into three groups: IPPV, ULTVV, and a sham control group. Juvenile male pigs underwent CPR after inducing ventricular fibrillation and received the designated ventilation intervention [IPPV: tidal volume 6–8 ml per kilogram body weight (ml/kg BW), respiratory rate 10/min, FiO2 1.0; ULTVV: tidal volume 2–3 ml/kg BW, respiratory rate 50/min, FiO2 1.0]. A 20-h observation period followed if return of spontaneous circulation was achieved. Histopathological examination using the diffuse alveolar damage scoring system was performed on postmortem lung tissue samples. Arterial and venous blood gas analyses and ventilation/perfusion measurements via multiple inert gas elimination technique (MIGET) were repeatedly recorded during the experiment. Results Out of the 45 experiments conducted, 28 animals were excluded based on predefined criteria. Histopathological analysis showed no significant differences in lung damage between the ULTVV and IPPV groups. ULTVV demonstrated adequate oxygenation and decarboxylation. MIGET measurements during and after resuscitation revealed no significant differences between the intervention groups. Conclusion In the short-term follow-up phase, ULTVV demonstrated similar histopathological changes and functional pulmonary parameters compared to standard ventilation. Further research is needed to investigate the long-term effects and clinical implications of ULTVV in resuscitation settings. |
| first_indexed | 2024-03-09T15:32:58Z |
| format | Article |
| id | doaj.art-36bb04e8503e4ae08f26576e75c5c655 |
| institution | Directory Open Access Journal |
| issn | 2197-425X |
| language | English |
| last_indexed | 2024-03-09T15:32:58Z |
| publishDate | 2023-11-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Intensive Care Medicine Experimental |
| spelling | doaj.art-36bb04e8503e4ae08f26576e75c5c6552023-11-26T12:08:49ZengSpringerOpenIntensive Care Medicine Experimental2197-425X2023-11-0111111110.1186/s40635-023-00568-6Ultra-low tidal volume ventilation during cardiopulmonary resuscitation shows no mitigating effect on pulmonary end-organ damage compared to standard ventilation: insights from a porcine modelKatja Mohnke0Philipp Conzelmann1Miriam Renz2Julian Riedel3René Rissel4Andrea Urmann5Johanna Hain6Bastian Duenges7Alexander Ziebart8Robert Ruemmler9Department of Anesthesiology, Medical Center of Johannes Gutenberg UniversityDepartment of Anesthesiology, Medical Center of Johannes Gutenberg UniversityDepartment of Anesthesiology, Medical Center of Johannes Gutenberg UniversityDepartment of Anesthesiology, Medical Center of Johannes Gutenberg UniversityDepartment of Anesthesiology, Medical Center of Johannes Gutenberg UniversityDepartment of Anesthesiology, Medical Center of Johannes Gutenberg UniversityDepartment of Anesthesiology, Medical Center of Johannes Gutenberg UniversityDepartment of Anesthesiology, Medical Center of Johannes Gutenberg UniversityDepartment of Anesthesiology, Medical Center of Johannes Gutenberg UniversityDepartment of Anesthesiology, Medical Center of Johannes Gutenberg UniversityAbstract Objective This study aimed to determine whether ultra-low tidal volume ventilation (ULTVV) applied during cardiopulmonary resuscitation (CPR) compared with standard ventilation (intermittent positive pressure ventilation, IPPV) can reduce pulmonary end-organ damage in the post-resuscitation period. Methods A prospective, randomized trial was conducted using a porcine model (n = 45). The animals were divided into three groups: IPPV, ULTVV, and a sham control group. Juvenile male pigs underwent CPR after inducing ventricular fibrillation and received the designated ventilation intervention [IPPV: tidal volume 6–8 ml per kilogram body weight (ml/kg BW), respiratory rate 10/min, FiO2 1.0; ULTVV: tidal volume 2–3 ml/kg BW, respiratory rate 50/min, FiO2 1.0]. A 20-h observation period followed if return of spontaneous circulation was achieved. Histopathological examination using the diffuse alveolar damage scoring system was performed on postmortem lung tissue samples. Arterial and venous blood gas analyses and ventilation/perfusion measurements via multiple inert gas elimination technique (MIGET) were repeatedly recorded during the experiment. Results Out of the 45 experiments conducted, 28 animals were excluded based on predefined criteria. Histopathological analysis showed no significant differences in lung damage between the ULTVV and IPPV groups. ULTVV demonstrated adequate oxygenation and decarboxylation. MIGET measurements during and after resuscitation revealed no significant differences between the intervention groups. Conclusion In the short-term follow-up phase, ULTVV demonstrated similar histopathological changes and functional pulmonary parameters compared to standard ventilation. Further research is needed to investigate the long-term effects and clinical implications of ULTVV in resuscitation settings.https://doi.org/10.1186/s40635-023-00568-6ResuscitationVentilationULTVVARDSMIGET |
| spellingShingle | Katja Mohnke Philipp Conzelmann Miriam Renz Julian Riedel René Rissel Andrea Urmann Johanna Hain Bastian Duenges Alexander Ziebart Robert Ruemmler Ultra-low tidal volume ventilation during cardiopulmonary resuscitation shows no mitigating effect on pulmonary end-organ damage compared to standard ventilation: insights from a porcine model Intensive Care Medicine Experimental Resuscitation Ventilation ULTVV ARDS MIGET |
| title | Ultra-low tidal volume ventilation during cardiopulmonary resuscitation shows no mitigating effect on pulmonary end-organ damage compared to standard ventilation: insights from a porcine model |
| title_full | Ultra-low tidal volume ventilation during cardiopulmonary resuscitation shows no mitigating effect on pulmonary end-organ damage compared to standard ventilation: insights from a porcine model |
| title_fullStr | Ultra-low tidal volume ventilation during cardiopulmonary resuscitation shows no mitigating effect on pulmonary end-organ damage compared to standard ventilation: insights from a porcine model |
| title_full_unstemmed | Ultra-low tidal volume ventilation during cardiopulmonary resuscitation shows no mitigating effect on pulmonary end-organ damage compared to standard ventilation: insights from a porcine model |
| title_short | Ultra-low tidal volume ventilation during cardiopulmonary resuscitation shows no mitigating effect on pulmonary end-organ damage compared to standard ventilation: insights from a porcine model |
| title_sort | ultra low tidal volume ventilation during cardiopulmonary resuscitation shows no mitigating effect on pulmonary end organ damage compared to standard ventilation insights from a porcine model |
| topic | Resuscitation Ventilation ULTVV ARDS MIGET |
| url | https://doi.org/10.1186/s40635-023-00568-6 |
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