Fluctuating CPAP (F-CPAP) versus conventional CPAP (C-CPAP) in dogs with blood aspiration |
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| Authors: | Mieko Sakurada Hideo Inaba Jiro Sato Haruo Uchida Tetsuro Ohwada Tadanobu Mizuguchi |
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| Institution: | (1) Department of Anesthesiology, School of Medicine, Chiba University, Chiba, Japan;(2) Department of Anesthesiology, School of Medicine, Chiba University, 1-8-1 Inohana, Chiba, 280, Japan |
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| Abstract: | Fluctuating CPAP(F-CPAP) is a combination of spontaneous ventilation and fluctuating PEEP, in which end-expiratory pressure (EEP) is periodically changed within a certain range. In a dog model with localized lung injury induced by the aspiration of non-heparinized blood (2 ml·kg–1 body weight), we carried out a comparative study of the effects of F-CPAP in which the EEP was cyclically changed from 4 to 12cmH2O with periods of 10min and those of conventional CPAP with a fixed EEP of 8cmH2O (C-CPAP), on hemodynamics and pulmonary oxygenation. The blood aspiration produced significant increases in the intrapulmonary shunt (
sp/
t), the alveolar-arterial difference of partial pressure of oxygen (A-aDo
2), and the respiratory rate (RR). Although both F-CPAP and C-CPAP reduced
sp/
t and A-aDo
2 and RR, 7 dogs treated with F-CPAP showed a significantly greater recovery of
sp/
t and A-aDo
2 than 7 dogs treated with C-CPAP. There were no significant differences in hemodynamic variables between the two groups. These results suggest that F-CPAP is more useful in the treatment of some kinds of hypoxic respiratory failure due to uneven distribution of lung injury.(Sakurada M, Inaba H, Sato J, et al.: Fluctuating CPAP (F-CPAP) versus conventional CPAP (C-CPAP) in dogs with blood aspiration. J Anesth 5: 36–42, 1991) |
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| Keywords: | Fluctuating positive end-expiratory pressure Fluctuating continuous positive airway pressure Alveolar-arterial difference of partial pressure of oxygen Intrapulmonary shunt Cardiac output |
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