BIOMAT Database Logo BIOMAT Database Logo

Positive end-expiratory pressure ventilation increases extravascular lung water due to a decrease in lung lymph flow. 2006

D M Maybauer, and P O Talke, and M Westphal, and M O Maybauer, and L D Traber, and P Enkhbaatar, and N Morita, and D L Traber
Department of Anaesthesiology, Investigational Intensive Care Unit, The University of Texas Medical Branch, and Shriners Burns Hospital for Children at Galveston, USA.

Positive end-expiratory pressure (PEEP) is used to improve gas exchange, increase functional residual capacity, recruit air spaces, and decrease pulmonary shunt in patients suffering from respiratory failure. The effect of PEEP on extravascular lung water (EVLW), however, is still not fully understood. This study was designed as a prospective laboratory experiment to evaluate the effects of PEEP on EVLW and pulmonary lymph flow (QL) under physiologic conditions. Twelve adult sheep were operatively prepared to measure haemodynamics of the systemic and pulmonary circulation, and to assess EVLW In addition, the lung lymphatic duct was cannulated and a tracheostomy performed. The animals were then mechanically ventilated in the awake-state without end-expiratory pressure (PEEP 0). After a two-hour baseline period, PEEP was increased to 10 cmH2O for the duration of two hours, and then reduced back to 0 cmH2O. Cardiopulmonary variables, QL, and arterial blood gases were recorded intermittently; EVLW was determined two hours after each change in PEEP. The increase in PEEP resulted in a decrease in QL (7 +/- 1 vs 5 +/- 1 ml/h) and an increase in EVLW (498 +/- 40 vs 630 +/- 58 ml; P<0.05 each) without affecting cardiac output. As PEEP was decreased back to baseline, QL increased significantly (5 +/- 1 vs 10 +/- 2 ml/h), whereas EVLW returned back to baseline. This study suggests that institution of PEEP produces a reversible increase in EVLW that is linked to a decrease in QL.

UI MeSH Term Description Entries
D008168 Lung Either of the pair of organs occupying the cavity of the thorax that effect the aeration of the blood. Lungs
D008196 Lymph The interstitial fluid that is in the LYMPHATIC SYSTEM. Lymphs
D011175 Positive-Pressure Respiration A method of mechanical ventilation in which pressure is maintained to increase the volume of gas remaining in the lungs at the end of expiration, thus reducing the shunting of blood through the lungs and improving gas exchange. Positive End-Expiratory Pressure,Positive-Pressure Ventilation,End-Expiratory Pressure, Positive,End-Expiratory Pressures, Positive,Positive End Expiratory Pressure,Positive End-Expiratory Pressures,Positive Pressure Respiration,Positive Pressure Ventilation,Positive-Pressure Respirations,Positive-Pressure Ventilations,Pressure, Positive End-Expiratory,Pressures, Positive End-Expiratory,Respiration, Positive-Pressure,Respirations, Positive-Pressure,Ventilation, Positive-Pressure,Ventilations, Positive-Pressure
D005260 Female Females
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D012756 Sheep Any of the ruminant mammals with curved horns in the genus Ovis, family Bovidae. They possess lachrymal grooves and interdigital glands, which are absent in GOATS. Ovis,Sheep, Dall,Dall Sheep,Ovis dalli
D015633 Extravascular Lung Water Water content outside of the lung vasculature. About 80% of a normal lung is made up of water, including intracellular, interstitial, and blood water. Failure to maintain the normal homeostatic fluid exchange between the vascular space and the interstitium of the lungs can result in PULMONARY EDEMA and flooding of the alveolar space. Lung Water, Extravascular,Extra Vascular Lung Water,Lung Water, Extra Vascular,Water, Extravascular Lung

Related Publications

D M Maybauer, and P O Talke, and M Westphal, and M O Maybauer, and L D Traber, and P Enkhbaatar, and N Morita, and D L Traber
Role of positive end-expiratory pressure in extravascular lung water decrease.
June 1997, Critical care medicine,
D M Maybauer, and P O Talke, and M Westphal, and M O Maybauer, and L D Traber, and P Enkhbaatar, and N Morita, and D L Traber
Ventilation with positive end-expiratory pressure reduces extravascular lung water and increases lymphatic flow in hydrostatic pulmonary edema.
September 1996, Critical care medicine,
D M Maybauer, and P O Talke, and M Westphal, and M O Maybauer, and L D Traber, and P Enkhbaatar, and N Morita, and D L Traber
Immediate application of positive-end expiratory pressure is more effective than delayed positive-end expiratory pressure to reduce extravascular lung water.
February 1999, Critical care medicine,
D M Maybauer, and P O Talke, and M Westphal, and M O Maybauer, and L D Traber, and P Enkhbaatar, and N Morita, and D L Traber
Effect of positive end-expiratory pressure on extravascular lung water in porcine acute respiratory failure.
January 1988, Critical care medicine,
D M Maybauer, and P O Talke, and M Westphal, and M O Maybauer, and L D Traber, and P Enkhbaatar, and N Morita, and D L Traber
Effect of positive end-expiratory pressure on extravascular lung water in porcine acute respiratory failure.
November 1989, Critical care medicine,
D M Maybauer, and P O Talke, and M Westphal, and M O Maybauer, and L D Traber, and P Enkhbaatar, and N Morita, and D L Traber
The effect of increasing end-expiratory pressure on extravascular lung water.
September 1981, Surgery,
D M Maybauer, and P O Talke, and M Westphal, and M O Maybauer, and L D Traber, and P Enkhbaatar, and N Morita, and D L Traber
[The effect of positive end-expiratory pressure (PEEP) on extravascular lung water in intensive care patients].
April 1986, Schweizerische medizinische Wochenschrift,
D M Maybauer, and P O Talke, and M Westphal, and M O Maybauer, and L D Traber, and P Enkhbaatar, and N Morita, and D L Traber
Failure of positive end-expiratory pressure to decrease lung water content in alloxan-induced pulmonary edema.
October 1979, The American review of respiratory disease,
D M Maybauer, and P O Talke, and M Westphal, and M O Maybauer, and L D Traber, and P Enkhbaatar, and N Morita, and D L Traber
Instantaneous blood flow responses to positive end-expiratory pressure with spontaneous ventilation.
June 1979, Circulation,
D M Maybauer, and P O Talke, and M Westphal, and M O Maybauer, and L D Traber, and P Enkhbaatar, and N Morita, and D L Traber
Positive end-expiratory pressure and surfactant decrease lung injury during initiation of ventilation in fetal sheep.
November 2011, American journal of physiology. Lung cellular and molecular physiology,
Copied contents to your clipboard!