Experimental Study Of Different Lung Protective Ventilation Modes In The Management Of Acute Lung Injury

In our study, we investigated the effects of different modes of lung protective ventilation in ARDS animal models on the characters of primarily from pulmonary/extra-pulmonary factors, inhomogenous and morphological differences of lung changes.Part 1.48 male rabbits were randomly divided into experimental groups (upper area group, abdominal area group, and dorsal area group) and conventional groups (upper area group, abdominal area group, and dorsal area group), and each group had 8 rabbits. After tracheotomy, the rabbits were ventilated with Servo 900C ventilator (infant modes). Opening the local area of right lung (upper area, abdominal area, or dorsal area), the experimental rabbits were induced acute lung injury by injecting oleic acid, and then received low tidal volume (Vj: 8ml/kg) + PEEP (LrP+3cmH2O) ventilation, prone position + large tidal volume (?: 14~17ml/kg) ventilation, and prone position + low tidal volume (VT: 8ml/kg) + PEEP (LIP+ScmHiO) ventilation- 6-randomly The results of respiratory mechanics, homodynamicmechanics, arterial blood gas, and effective local area lung bloodperfusion index (Using PIM-II laser perfusion imager) were measuredbefore and after lung injury (including receiving lung protectiveventilation).The results showed that the results of respiratory mechanics weresignificantly getting worsen after lung injury central vein pressure andoxygenation index obviously decreased. After receiving lungprotective vefltilation (including low tidal volume + PEEP, proneposition + low tidal volume + PEEP), these index were taking a tum tothe better. Although the results displayed gradually getting we11,compared with lung protective ventilation, there showed statisticaldifferences. After lung injury the results of effective local area lungblood perfusion index (including uPper area, abdominal area, anddorsal area) under right pleura of injured rabbits decreased in theexperimental grouPs. The results of experimental dorsal area grouPdecreased most significantly, and the results of experimental upperarea grouP changed most lightly We observed that the effects ofreceiving low tidal volume + PEEP votilation were not as good asprone position + low tidal volume + PEEP ventilation in the dorsalarea of the rabbit lung comPared the results of effective local area lungblood peffosion index between tWo ventilation modes, there showedsignificantly differences in statistics.Part 236 male mongrel dogs were randomly divided into injectinggroups [low tidal volume (VT:8ml&g) + PEEP (l0cmH2O) ventilationgrouP with injecting oleic acid, prone position + low tidal vo1ume(VT:8ml/kg) + PEEP (l0cmH2O) ventilation group with injecting oleicacid, and large tidal volume (VTfl4~l7mimg) ventilation group withinjecting oleic acid1 and inhaling groups [low tidal volume (VT:8mimg)+ PEEP (l0cmH2O) ventilation grOup with inhaling detergent, proneposition + low tidal volume (VT:8ml/kg) + PEEP (l0cdri2O)ventilation grouP with inhaling detergent, and lnse tidal volume(VT:l4~l7ml/kg) ventilation group with inhaling detergent1, eachgrouP had 6 dogs. After tracheotomy, the dogs were venilated withServo 900C ventilator (infant modes). The acute lung injury models(injecting grouPs) which primarily from extra-pulmonary factor wereformed by infusing oleic acid, and the models (inhaling grouPs) whichprimarily from pulmonary factor were formed by inhaling detergellt.The results of respiratory mechanics, homodynamic mechanics,aterial blood gaS, and inflaInInatory factors [TNF- Q, IL-l fl, IL-6,IL-l0, and adrenomedulin (ADM)] which detected in animal serumand bronchial alveolar lavage fluid (BALF) obtained from tiP lObe,heart lobe, and diaPhragIn lobe of right lung seParate1y in the mongreldogs were measured before and after lung injury (including receivinglung protective ventilation).The results showed that the results of respiratory mechanics,hemodynamic mechanics, and arterial bl...