Effect of PEEP on dead space in an experimental model of ARDS

"Background: Difference between Bohr and Enghoff dead space are not well described in ARDS patients. We aimed to analyze the effect of PEEP on the Bohr and Enghoff dead spaces in a model of ARDS. Methods: 10 pigs submitted to randomized PEEP steps of 0, 5, 10, 15, 20, 25 and 30 cm H2O were e...

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Autores principales: Tusman, Gerardo, Gogniat, Emiliano, Madorno, Matías, Otero, Pablo, Dianti, José, Fernández Ceballos, Ignacio, Ceballos, Martín, Verdier, Natalí, Böhm, Stephan H., Rodríguez, Pablo Oscar, San Román, Eduardo
Formato: Artículos de Publicaciones Periódicas acceptedVersion
Lenguaje:Español
Publicado: 2020
Materias:
CAPNOGRAFIA
SINDROME DE DIFICULTAD RESPIRATORIA DEL ADULTO
DIOXIDO DE CARBONO
Acceso en línea:http://ri.itba.edu.ar/handle/123456789/3262
Aporte de:
Repositorio Institucional Instituto Tecnológico de Buenos Aires (ITBA) de Instituto Tecnológico de Buenos Aires (ITBA)
id I32-R138-123456789-3262
record_format dspace
spelling I32-R138-123456789-32622022-12-07T13:05:58Z Effect of PEEP on dead space in an experimental model of ARDS Tusman, Gerardo Gogniat, Emiliano Madorno, Matías Otero, Pablo Dianti, José Fernández Ceballos, Ignacio Ceballos, Martín Verdier, Natalí Böhm, Stephan H. Rodríguez, Pablo Oscar San Román, Eduardo CAPNOGRAFIA SINDROME DE DIFICULTAD RESPIRATORIA DEL ADULTO DIOXIDO DE CARBONO "Background: Difference between Bohr and Enghoff dead space are not well described in ARDS patients. We aimed to analyze the effect of PEEP on the Bohr and Enghoff dead spaces in a model of ARDS. Methods: 10 pigs submitted to randomized PEEP steps of 0, 5, 10, 15, 20, 25 and 30 cm H2O were evaluated with the use of lung ultrasound images, alveolar-arterial oxygen difference (P(A-a)O2), transpulmonary mechanics, and volumetric capnography at each PEEP step. Results: At PEEP > 15 cm H2O, atelectasis and P(A-a)O2 progressively decreased while endinspiratory transpulmonary pressure (PL), end-expiratory PL, and driving PL increased (all P < .001). Bohr dead space (VDBohr/VT), airway dead space (VDaw/VT), and alveolar dead space (VDalv/VTalv) reached their highest values at PEEP 30 cm H2O (0.69 0.10, 0.53 0.13 and 0.35 0.06, respectively). At PEEP <15 cm H2O, the increases in atelectasis and P(A-a)O2 were associated with negative end-expiratory PL and highest driving PL. VDBohr/VT and VDaw/VT showed the lowest values at PEEP 0 cm H2O (0.51 0.08 and 0.32 0.08, respectively), whereas VDalv/VTalv increased to 0.27 0.05. Enghoff dead space and its derived VDalv/VTalv showed high values at low PEEPs (0.86 0.02 and 0.79 0.04, respectively) and at high PEEPs (0.84 0.04 and 0.65 0.12), with the lowest values at 15 cm H2O (0.77 0.05 and 0.61 0.11, respectively; all P < .001). CONCLUSIONS: Bohr dead space was associated to lung stress, whereas Enghoff dead space was partially affected by the shunt effect. Key words: dead space; PEEP; lung stress; ARDS; VILI; carbon dioxide." 2020-12-17T20:08:43Z 2020-12-17T20:08:43Z 2020 Artículos de Publicaciones Periódicas info:eu-repo/semantics/acceptedVersion 0020-1324 http://ri.itba.edu.ar/handle/123456789/3262 es info:eu-repo/semantics/altIdentifier/doi/10.4187/respcare.06843 info:eu-repo/semantics/embargoedAccess/2021-12-17 application/pdf
institution Instituto Tecnológico de Buenos Aires (ITBA)
institution_str I-32
repository_str R-138
collection Repositorio Institucional Instituto Tecnológico de Buenos Aires (ITBA)
language Español
topic CAPNOGRAFIA
SINDROME DE DIFICULTAD RESPIRATORIA DEL ADULTO
DIOXIDO DE CARBONO
spellingShingle CAPNOGRAFIA
SINDROME DE DIFICULTAD RESPIRATORIA DEL ADULTO
DIOXIDO DE CARBONO
Tusman, Gerardo
Gogniat, Emiliano
Madorno, Matías
Otero, Pablo
Dianti, José
Fernández Ceballos, Ignacio
Ceballos, Martín
Verdier, Natalí
Böhm, Stephan H.
Rodríguez, Pablo Oscar
San Román, Eduardo
Effect of PEEP on dead space in an experimental model of ARDS
topic_facet CAPNOGRAFIA
SINDROME DE DIFICULTAD RESPIRATORIA DEL ADULTO
DIOXIDO DE CARBONO
description "Background: Difference between Bohr and Enghoff dead space are not well described in ARDS patients. We aimed to analyze the effect of PEEP on the Bohr and Enghoff dead spaces in a model of ARDS. Methods: 10 pigs submitted to randomized PEEP steps of 0, 5, 10, 15, 20, 25 and 30 cm H2O were evaluated with the use of lung ultrasound images, alveolar-arterial oxygen difference (P(A-a)O2), transpulmonary mechanics, and volumetric capnography at each PEEP step. Results: At PEEP > 15 cm H2O, atelectasis and P(A-a)O2 progressively decreased while endinspiratory transpulmonary pressure (PL), end-expiratory PL, and driving PL increased (all P < .001). Bohr dead space (VDBohr/VT), airway dead space (VDaw/VT), and alveolar dead space (VDalv/VTalv) reached their highest values at PEEP 30 cm H2O (0.69 0.10, 0.53 0.13 and 0.35 0.06, respectively). At PEEP <15 cm H2O, the increases in atelectasis and P(A-a)O2 were associated with negative end-expiratory PL and highest driving PL. VDBohr/VT and VDaw/VT showed the lowest values at PEEP 0 cm H2O (0.51 0.08 and 0.32 0.08, respectively), whereas VDalv/VTalv increased to 0.27 0.05. Enghoff dead space and its derived VDalv/VTalv showed high values at low PEEPs (0.86 0.02 and 0.79 0.04, respectively) and at high PEEPs (0.84 0.04 and 0.65 0.12), with the lowest values at 15 cm H2O (0.77 0.05 and 0.61 0.11, respectively; all P < .001). CONCLUSIONS: Bohr dead space was associated to lung stress, whereas Enghoff dead space was partially affected by the shunt effect. Key words: dead space; PEEP; lung stress; ARDS; VILI; carbon dioxide."
format Artículos de Publicaciones Periódicas
acceptedVersion
author Tusman, Gerardo
Gogniat, Emiliano
Madorno, Matías
Otero, Pablo
Dianti, José
Fernández Ceballos, Ignacio
Ceballos, Martín
Verdier, Natalí
Böhm, Stephan H.
Rodríguez, Pablo Oscar
San Román, Eduardo
author_facet Tusman, Gerardo
Gogniat, Emiliano
Madorno, Matías
Otero, Pablo
Dianti, José
Fernández Ceballos, Ignacio
Ceballos, Martín
Verdier, Natalí
Böhm, Stephan H.
Rodríguez, Pablo Oscar
San Román, Eduardo
author_sort Tusman, Gerardo
title Effect of PEEP on dead space in an experimental model of ARDS
title_short Effect of PEEP on dead space in an experimental model of ARDS
title_full Effect of PEEP on dead space in an experimental model of ARDS
title_fullStr Effect of PEEP on dead space in an experimental model of ARDS
title_full_unstemmed Effect of PEEP on dead space in an experimental model of ARDS
title_sort effect of peep on dead space in an experimental model of ards
publishDate 2020
url http://ri.itba.edu.ar/handle/123456789/3262
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