Analysis of different levels of positive end-expiratory pressure during lung retrieval for transplantation: an experimental study
Atelectasis and inadequate oxygenation in lung donors is a common problem during the retrieval of these organs. Nevertheless, the use of high positive end-expiratory pressure (PEEP) is not habitual during procedures of lung retrieval. Twenty-one Sprague-Dawley male consanguineous rats were used in t...
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| Format: | Article |
| Language: | English |
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Associação Brasileira de Divulgação Científica
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| Series: | Brazilian Journal of Medical and Biological Research |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2019000700607&lng=en&tlng=en |
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| author | W.A. Gonçalves-Ferri A. Jauregui F.P. Martins-Celini I. Sansano A.T. Fabro E.M.F. Sacramento D.C. Aragon J.M. Ochoa |
| author_facet | W.A. Gonçalves-Ferri A. Jauregui F.P. Martins-Celini I. Sansano A.T. Fabro E.M.F. Sacramento D.C. Aragon J.M. Ochoa |
| author_sort | W.A. Gonçalves-Ferri |
| collection | DOAJ |
| description | Atelectasis and inadequate oxygenation in lung donors is a common problem during the retrieval of these organs. Nevertheless, the use of high positive end-expiratory pressure (PEEP) is not habitual during procedures of lung retrieval. Twenty-one Sprague-Dawley male consanguineous rats were used in the study. The animals were divided into 3 groups according to the level of PEEP used: low (2 cmH2O), moderate (5 cmH2O), and high (10 cmH2O). Animals were ventilated with a tidal volume of 6 mL/kg. Before lung removal, the lungs were inspected for the presence of atelectasis. When atelectasis was detected, alveolar recruitment maneuvers were performed. Blood gasometric analysis was performed immediately. Finally, the lungs were retrieved, weighed, and submitted to histological analysis. The animals submitted to higher PEEP showed higher levels of oxygenation with the same tidal volumes PO2=262.14 (PEEP 2), 382.4 (PEEP 5), and 477.0 (PEEP 10). The occurrence of atelectasis was rare in animals with a PEEP of 10 cmH2O, which therefore required less frequent recruitment maneuvers (need for recruitment: PEEP 2=100%, PEEP 5 =100%, and PEEP 10=14.3%). There was no change in hemodynamic stability, occurrence of pulmonary edema, or other histological injuries with the use of high PEEP. The use of high PEEP (10 cmH2O) was feasible and probably a beneficial strategy for the prevention of atelectasis and the optimization of oxygenation during lung retrieval. Clinical studies should be performed to confirm this hypothesis. |
| first_indexed | 2024-04-13T02:45:01Z |
| format | Article |
| id | doaj.art-699baab6b2884c6b916d5dd689262ea0 |
| institution | Directory Open Access Journal |
| issn | 1414-431X |
| language | English |
| last_indexed | 2024-04-13T02:45:01Z |
| publisher | Associação Brasileira de Divulgação Científica |
| record_format | Article |
| series | Brazilian Journal of Medical and Biological Research |
| spelling | doaj.art-699baab6b2884c6b916d5dd689262ea02022-12-22T03:06:05ZengAssociação Brasileira de Divulgação CientíficaBrazilian Journal of Medical and Biological Research1414-431X52710.1590/1414-431x20198585S0100-879X2019000700607Analysis of different levels of positive end-expiratory pressure during lung retrieval for transplantation: an experimental studyW.A. Gonçalves-FerriA. JaureguiF.P. Martins-CeliniI. SansanoA.T. FabroE.M.F. SacramentoD.C. AragonJ.M. OchoaAtelectasis and inadequate oxygenation in lung donors is a common problem during the retrieval of these organs. Nevertheless, the use of high positive end-expiratory pressure (PEEP) is not habitual during procedures of lung retrieval. Twenty-one Sprague-Dawley male consanguineous rats were used in the study. The animals were divided into 3 groups according to the level of PEEP used: low (2 cmH2O), moderate (5 cmH2O), and high (10 cmH2O). Animals were ventilated with a tidal volume of 6 mL/kg. Before lung removal, the lungs were inspected for the presence of atelectasis. When atelectasis was detected, alveolar recruitment maneuvers were performed. Blood gasometric analysis was performed immediately. Finally, the lungs were retrieved, weighed, and submitted to histological analysis. The animals submitted to higher PEEP showed higher levels of oxygenation with the same tidal volumes PO2=262.14 (PEEP 2), 382.4 (PEEP 5), and 477.0 (PEEP 10). The occurrence of atelectasis was rare in animals with a PEEP of 10 cmH2O, which therefore required less frequent recruitment maneuvers (need for recruitment: PEEP 2=100%, PEEP 5 =100%, and PEEP 10=14.3%). There was no change in hemodynamic stability, occurrence of pulmonary edema, or other histological injuries with the use of high PEEP. The use of high PEEP (10 cmH2O) was feasible and probably a beneficial strategy for the prevention of atelectasis and the optimization of oxygenation during lung retrieval. Clinical studies should be performed to confirm this hypothesis.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2019000700607&lng=en&tlng=enAnesthesiaLung transplantationMechanical ventilationPulmonary recruitmentPEEP |
| spellingShingle | W.A. Gonçalves-Ferri A. Jauregui F.P. Martins-Celini I. Sansano A.T. Fabro E.M.F. Sacramento D.C. Aragon J.M. Ochoa Analysis of different levels of positive end-expiratory pressure during lung retrieval for transplantation: an experimental study Brazilian Journal of Medical and Biological Research Anesthesia Lung transplantation Mechanical ventilation Pulmonary recruitment PEEP |
| title | Analysis of different levels of positive end-expiratory pressure during lung retrieval for transplantation: an experimental study |
| title_full | Analysis of different levels of positive end-expiratory pressure during lung retrieval for transplantation: an experimental study |
| title_fullStr | Analysis of different levels of positive end-expiratory pressure during lung retrieval for transplantation: an experimental study |
| title_full_unstemmed | Analysis of different levels of positive end-expiratory pressure during lung retrieval for transplantation: an experimental study |
| title_short | Analysis of different levels of positive end-expiratory pressure during lung retrieval for transplantation: an experimental study |
| title_sort | analysis of different levels of positive end expiratory pressure during lung retrieval for transplantation an experimental study |
| topic | Anesthesia Lung transplantation Mechanical ventilation Pulmonary recruitment PEEP |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2019000700607&lng=en&tlng=en |
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