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Am. J. Respir. Crit. Care Med., Volume 157, Number 6, June 1998, 1935-1942

Consequences of Vascular Flow on Lung Injury Induced by Mechanical Ventilation

ALAIN F. BROCCARD, JOHN R. HOTCHKISS, NAOTO KUWAYAMA, DOUGLAS A. OLSON, SABA JAMAL, DOUGLAS O. WANGENSTEEN, and JOHN J. MARINI

Division of Pulmonary and Critical Care Medicine, University of Minnesota, Minneapolis/St. Paul; and Department of Laboratory Medicine and Pathology, Regions Hospital, St. Paul, Minnesota

To investigate whether the magnitude of blood flow contributes to ventilator-induced lung injury, 14 sets of isolated rabbit lungs were randomized for perfusion at either 300 (Group A: n = 7) or 900 ml/ min (Group B: n = 7) while ventilated with 30 cm H2O peak static pressure. Control lungs (Group C: n = 7) were ventilated with lower peak static pressure (15 cm H2O) and perfused at 500 ml/min. Weight gain, changes in the ultrafiltration coefficient (Delta Kf) and lung static compliance (CL), and extent of hemorrhage (scored by histology) were compared. Group B had a larger decrease in CL (-13 ± 11%) than Groups A (2 ± 6%) and C (5 ± 5%) (p < 0.05). Group B had more hemorrhage and gained more weight (16.2 ± 9.5 g) than Groups A (8.7 ± 3.4 g) and C (1.6 ± 1.0 g) (p < 0.05 for each pairwise comparison between groups). Finally, Kf (g · min-1 · cm H2O-1 · 100 g-1) increased the most in Group B (Delta Kf = 0.26 ± 0.20 versus 0.17 ± 0.10 in Group A and 0.05 ± 0.04 in Group C; p < 0.05 for B versus C). We conclude that the intensity of lung perfusion contributes to ventilator- induced lung injury in this model.




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