Effect of PEEP on regional ventilation and perfusion in the mechanically ventilated preterm lamb. 1989

J S Schlessel, and H Susskind, and D D Joel, and A Bossuyt, and W H Harrold, and I Zanzi, and A D Chanana
Department of Pediatrics, North Shore University Hospital, Cornell University Medical College, Manhasset, New York 11030.

Improvement of gas exchange through closer matching of regional ventilation (V) and lung perfusion (Q) with the application of positive end-expiratory pressure (PEEP) was evaluated in vivo in six mechanically ventilated preterm lambs (107-126 days/145 days gestation). Changes in V and Q were determined from in vivo scintigraphic measurements in four lung regions with inhaled radioactive 81mKr, and infused 81mKr/dextrose and/or [99mTc]MAA as PEEP was applied at 2, 4, and 6 cm H2O in each animal. Dynamic compliance varied between 0.02 and 0.40 ml/cm H2O, which was consistent with surfactant deficiency. As PEEP was increased, the regional distribution of Q shifted from the rostral to the caudal lung regions (p less than 0.02 to less than 0.05), while that of V remained unchanged. Regional V/Q matching improved together with a trend towards improvement of arterial blood gases as PEEP was increased from 2 to 4 cm H2O. Pulmonary scintigraphy offers a noninvasive methodology for the quantitative assessment of regional V and Q matching in preterm lambs and may be clinically applicable to ventilated neonates.

UI MeSH Term Description Entries
D007727 Krypton Radioisotopes Unstable isotopes of krypton that decay or disintegrate emitting radiation. Kr atoms with atomic weights 74-77, 79, 81, 85, and 87-94 are radioactive krypton isotopes. Radioisotopes, Krypton
D008168 Lung Either of the pair of organs occupying the cavity of the thorax that effect the aeration of the blood. Lungs
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
D011877 Radionuclide Imaging The production of an image obtained by cameras that detect the radioactive emissions of an injected radionuclide as it has distributed differentially throughout tissues in the body. The image obtained from a moving detector is called a scan, while the image obtained from a stationary camera device is called a scintiphotograph. Gamma Camera Imaging,Radioisotope Scanning,Scanning, Radioisotope,Scintigraphy,Scintiphotography,Imaging, Gamma Camera,Imaging, Radionuclide
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
D000831 Animals, Newborn Refers to animals in the period of time just after birth. Animals, Neonatal,Animal, Neonatal,Animal, Newborn,Neonatal Animal,Neonatal Animals,Newborn Animal,Newborn Animals
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
D013668 Technetium Tc 99m Aggregated Albumin A gamma-emitting radionuclide imaging agent used for the diagnosis of diseases in many tissues, particularly in cardiovascular and cerebral circulation. Tc 99m-Albumin,Tc 99m-Albumin Colloid,99m-Tc-HSA,99mTc-Albures,99mTc-HSA,99mTc-Human Serum Albumin,Tc-99m-HAM,Tc-99m-MAA,Tc-99m-Microalbumin,Tc-HAMM,Tc99m-Albumin,Technetium-99m Albumin Colloid,99mTc Albures,99mTc Human Serum Albumin,99mTcAlbures,Albumin Colloid, Technetium-99m,Albumin, 99mTc-Human Serum,Colloid, Tc 99m-Albumin,Colloid, Technetium-99m Albumin,Serum Albumin, 99mTc-Human,Tc 99m Albumin,Tc 99m Albumin Colloid,Tc 99m HAM,Tc 99m MAA,Tc 99m Microalbumin,Tc HAMM,Tc99m Albumin,Technetium 99m Albumin Colloid
D014692 Ventilation-Perfusion Ratio The ratio of alveolar ventilation to simultaneous alveolar capillary blood flow in any part of the lung. (Stedman, 25th ed) Ratio, Ventilation-Perfusion,Ratios, Ventilation-Perfusion,Ventilation Perfusion Ratio,Ventilation-Perfusion Ratios

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