Effect of combination of prone position and high-frequency oscillatory ventilation on blood gas exchange in experimental model of acute respiratory distress syndrome

Česká verzia

Authors: Žurek Jiří; Košut Petr; Dominik Petr; Šeda Miroslav; Klimovič Michal; Fedora Michal
Authors place of work: Klinika dětské anesteziologie a resuscitace LF MU a FN Brno
Published in the journal: Anest. intenziv. Med., 24, 2013, č. 1, s. 33-39
Category: Intensive Care Medicine - Original Paper

Summary

Objective:
The aim of the study was verification of the effect of combination of high-frequency oscillatory ventilation and prone position in an experimental model of acute respiratory distress syndrome.

Design:
Experimental study. Setting: Department of Anaesthesiology and Intensive Care Medicine, University Hospital.

Materials and Methods:
The study included 40 experimental piglets. Lung damage was induced by repeated bilateral lung lavage with saline to achieve PaO₂/FiO₂ < 100 mm Hg. The experimental animals were randomized into 5 groups - control group (PCV in supine position throughout the experiment), PP (PCV in prone position and then in supine position), HFOV (HFOV in supine position throughout the experiment), HFOV + PP (HFOV in supine position, after 6 hours of prone position and then supine position), PP + HFOV (PCV in prone position, after 6 hours HFOV, further rotation of supine and prone positions, as the PP group).

Results:
In terms of oxygenation (PaO₂) there was no difference between the PP and HFOV groups, higher values of PaO₂ were achieved in the PP+HFOV group than in the HFOV+PP group. CO₂ elimination was better in the HFOV+PP group than in the PP+HFOV group. There was no difference between the PP and HFOV groups. There was no difference in oxygenation index between the PP and HFOV groups, the PP+HFOV group had a lower oxygenation index than the HFOV + PP group.

Conclusion:
There were no differences in oxygenation and CO₂ elimination between the prone position and high-frequency oscillation groups. The combination of PP + HFOV is more efficient in terms of oxygenation.

Keywords:
acute respiratory distress syndrome – experiment – oxygenation – ventilation – prone position – HFO

Zdroje

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