Protective ventilation to reduce inflammatory injury from one lung ventilation in a piglet model

• Published in: Pediatric anesthesia 2010-04, Vol.20 (4), p.356-364
• Main Authors: THEROUX, MARY C., FISHER, ALICIA O., HORNER, LIANA M., RODRIGUEZ, MARIA E., COSTARINO, ANDREW T., MILLER, THOMAS L., SHAFFER, THOMAS H.
• Format: Article
• Language: English
• Subjects: Animals; Animals, Newborn; cytokines; Cytokines - metabolism; Disease Models, Animal; Lung - metabolism; one lung ventilation; piglets; Pneumonia - complications; Pneumonia - prevention & control; Positive-Pressure Respiration - methods; protective ventilation; Respiration, Artificial - adverse effects; Swine; thoracic anesthesia; Tidal Volume; Tumor Necrosis Factor-alpha - metabolism; Vascular Resistance; Ventilator-Induced Lung Injury - etiology; Ventilator-Induced Lung Injury - prevention & control
• ISSN: 1155-5645; 1460-9592
• DOI: 10.1111/j.1460-9592.2009.03195.x

Summary Objectives:  To test the hypothesis that protective ventilation strategy (PVS) as defined by the use of low stretch ventilation (tidal volume of 5 ml·kg−1 and employing 5 cm of positive end expiratory pressure (PEEP) during one lung ventilation (OLV) in piglets would result in reduced injury compared to a control group of piglets who received the conventional ventilation (tidal volume of 10 ml·kg−1 and no PEEP). Background:  PVS has been found to be beneficial in adults to minimize injury from OLV. We designed the current study to test the beneficial effects of PVS in a piglet model of OLV. Methods:  Ten piglets each were assigned to either ‘Control’ group (tidal volume of 10 ml·kg−1 and no PEEP) or ‘PVS’ group (tidal volume of 5 ml·kg−1 during the OLV phase and PEEP of 5 cm of H2O throughout the study). Experiment consisted of 30 min of baseline ventilation, 3 h of OLV, and again 30 min of bilateral ventilation. Respiratory parameters and proinflammatory markers were measured as outcome. Results:  There was no difference in PaO2 between groups. PaCO2 (P